OMB 83c

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/Subagency Department of Education/Institute of Education Sciences		OMB Control Number 1 8 5 0 - 0 8 3 4
	Enter only items that change Current Record	New Record
Agency form number(s)
Annual reporting and record keeping hour burden
Number of respondent	15,383	15,383
Total annual responses	15,383	15,383
Percent of these responses collected electronically
Total annual hours	6,407	6,407
Difference
Explanation of difference
Program change adjustment		0
Annual reporting and record keeping 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		0
Other change** Add Exhibit J, “Classroom Observation Protocol”, to Supporting Statement A of OMB# 1850-0834, “The Effects of Connected Mathematics 2 (CM2) on the Math Achievement of Middle School Students”. This addendum has no effect on burden estimates. Exhibit J was mentioned in the original application as a protocol that was to be developed. The cost and burden of the implementation fidelity work was contained in the original clearance package approved by OMB.
Signature of Senior Official or designee:	Date:	For OIRA Use _________________________________ _________________________________

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

OMB 83-C