Change Justification Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S. Department of Education/Office of Postsecondary Education
Enter only items that change
Current record

0849
1840
___ ___
___ ___ - ___
___ ___ ___

New record

Agency form number (s)

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 instructions for this currently approved collection have been modified to clarify the format in which reports should be
posted and specify a naming convention for the report file. There are no changes to the report itself, nor will these clarified
instructions have any impact on burden.
Signature of Senior Official or designee:
signed by LAUREN KENNEDY
LAUREN KENNEDY Digitally
Date: 2021.09.22 09:53:12 -04'00'

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

OMB 83-C

Date:

9/22/21

For OIRA Use
___________________________________
___________________________________

10/95