Change Justification Form

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/Subagency       Department of Education		OMB Control Number 1840-0616    
Enter only items that change Current Record New Record
Agency form number(s)	     	     
Annual reporting and record keeping hour burden
Number of respondents	27	27
Total annual responses	1	1
Percent of these responses collected electronically	100%	100%      
Total annual hours	2700	2,075
Difference		625
Explanation of difference Program Change		Agency Discretion
Adjustment		     
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		     
Other change** The PMF is no longer required of the CIBE applicants. We no longer require the PMF form as the performance measures do not collect data that can used to evaluate program outputs and outcomes. The performance measures that each applicant develop are individually specific to their project and do not collect data that inform GPRA measures. Each grantee is evaluated and assessed by an annual performance report which gathers specific information concerning their project goals and activities. The PMF is redundant and not informative to report on program evaluation. Elimination of the required form will reduce burden on the applicant.
Signature of Senior Officer or designee:       Sara Starke	Date:       03/18/2021	For OIRA Use            

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

OMB 83-C