Change Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education, OPEPD
1840

Enter only items that change
Current record

Agency form number (s)

-

0850

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 purpose of this non-substantive change is to add the display of a field for "HEERF Award Amount" in Question 1c. The
award amount will be prefilled from G5 and is provided for information purposes only. No additional data collection is involved.

Signature of Senior Official or designee:

Sharon Boivin

Digitally signed by Sharon Boivin
Date: 2020.12.14 07:06:02 -05'00'

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

OMB 83-C

Date:

For OIRA Use
___________________________________
___________________________________

10/95