83-C Form

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB control number

DHS/CBP

1

6

5

1

0

0

8

6

Enter only items that change
Current record
New record
Agency form number(s)

Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses
Percent of these responses
collected electronically

%

%

Total annual hours
Difference

0

Explanation of difference
Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)
Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested

0.00

Difference

0.00
0.00

Explanation of difference
Program change
Adjustment
Other changes**
1) Update the Pay.gov instructions included as page 5 of CBP Form 7401. Minor language changes and reordering of instructions needed due to
Pay.gov modernization of online platform. 2) correct spelling error on page 1. 3) Change CBP Mailing address on pages 2 and 5.
Signature of Senior Official or designee:
signed by ROBIN L BATT
ROBIN L BATT Digitally
Date: 2024.05.16 09:17:57 -04'00'

**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95

Date:

For OIRA Use

5/16/2024

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