Change Justification Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S. Department of Education/Office of Postsecondary Education

0842
1840
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Enter only items that change
Current record

New record

Agency form number (s)

Annual reporting and recordkeeping hour
burden
Number of respondents

5,885

5,935

Total annual responses

5,885

5,935

Percent of these responses
collected electronically
Total annual hours

%
3,753

%
4,003

Difference

250

Explanation of difference

50 applicants x 5 hours = 250 hours

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**

Respondent and burden increases include grantees who did not receive institutional aid funding under the CARES Act or the
Coronavirus Response and Relief Supplemental Appropriations Act, 2021 but will be eligible to apply for similar funding under
the American Rescue Plan Act of 2021. We expect 50 applicants at 5 hours each, for a total of 250 hours.
Signature of Senior Official or designee:
signed by Lauren Kennedy
Lauren Kennedy Digitally
Date: 2021.04.27 09:42:55 -04'00'

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

OMB 83-C

Date:

4/27/21

For OIRA Use
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10/95