Justification Change Worksheet

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB Control Number

US Department of Education / Office of Elementary and Secondary Education

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

1894-0006

New Record
N/A

Annual reporting and record keeping
hour burden
Number of respondents

15

Total annual responses

15

Percent of these responses
collected electronically

100

Total annual hours

900

Difference

15 (respondents) X 60 (hours) =
900 hours
New program requesting approval
to use 1894-0006

Explanation of difference
Program Change

900 hours

Adjustment
Annual reporting and record keeping
cost burden (in thousands of dollars)
Total annualized capital/startup
costs

0

Total annual costs (O&M)

0

Total annualized cost requested

0

Difference

0
0

Explanation of difference
Program Change
Adjustment

0

Other change**
The Well-Rounded Education through Student-Centered Funding Demonstration Grants program provides
competitive grants to local educational agencies (LEAs) to demonstrate model programs for providing wellrounded educational opportunities through the development and implementation of student-centered funding
(SCF) systems based on weighted per-pupil allocations under section 1501 of the Elementary and Secondary
Education Act of 1965 (ESEA), as amended (ESSA).
Signature of Senior Officer or
designee:

For OIRA Use

Date:
April 23, 2020

**This form cannot be used to extend an expiration date
OMB 83-C