OMB 83C Form

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education
1850

Enter only items that change
Current record

Agency form number (s)

-

0991

New record

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

%

%

Total annual hours
Difference
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
Difference
Explanation of difference
Program change
Adjustment
Other changes
The study team proposes to revise question two of the implementation checklist to replace the word “Which” with “How much,” so that the wording is “How
much of the following toolkit learning activities did you implement?” In addition, the study team proposes changing the response options to None/Some/All, to
encourage honest responses and reflect that it is acceptable that some teachers may not have completed all components of all toolkit learning activities.

Signature of Senior Official or designee:

MATTHEW SOLDNER

Digitally signed by MATTHEW SOLDNER
Date: 2024.12.30 12:13:35 -05'00'

** This form cannot be used to extend an expiration date.

OMB 83-C

Date:

For OIRA Use
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10/95