Change Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/Subagency       Department of Education – FSAOSERS – State Plan for Assistive TechnologyDirect Loan Schools Survey		OMB Control Number 184520-0664045v. 26     -    
Enter only items that change Current Record New Record
Agency form number(s)	NA     	      NA
Annual reporting and record keeping hour burden
Number of respondents	12,00056     	12,00056      
Total annual responses	12,000     56	12,00056     
Percent of these responses collected electronically	     1000%	     100%
Total annual hours	5,0402,900     	2,900     4,816
Difference		     224NA
Explanation of difference Program Change		NA224     
Adjustment		NA0     
Annual reporting and record keeping cost burden (in thousands of dollars)
Total annualized capital/startup costs	NA     	NA     
Total annual costs (O&M)	NA     	NA     
Total annualized cost requested	     NA	NA     
Difference		NA     
Explanation of difference Program Change		      NA
Adjustment		NA     
Other change**      This collection does not increase the burden on the general public, as prior OMB approval has been received under the master plan for customer satisfaction surveys. This survey falls under the master plan guidelines.See attached
Signature of Senior Officer or designee:      	Date: December 5     , 2005	For OIRA Use            

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

OMB 83-CExplanation for Change

Attachment 4 of this information collection requires grantees to provide baseline data and short-term and long-term goals for seven performance measures. As originally developed, grantees were to submit this information to the Rehabilitation Services Administration (RSA) on paper. RSA proposes instead to create an online Attachment 4 so that grantees can enter their baselines, long-term goals and short-term goals electronically. The content of Attachment 4 will not be changed, nor will new or different information be collected. The only difference will be the mode of completing the attachment.

Further, the raw data that these grantees use to calculate their baselines and annual performance on their goals currently is entered electronically via a separate online data collection system (OMB Control Number 1820-0572 – Annual Progress Report and Data Collection Instrument Form for Assistive Technology Grantees). This system can be configured to automatically do calculations and submit the Attachment for the grantees. Once calculated, this data can automatically be transferred from 1820-0572 into 1820-0664, saving grantees the need to enter their baselines and annual performance themselves. So, instead of having to calculate a baseline and enter it into the system, then calculate their performance and enter it into the system, the only data entry grantees would be responsible for would be entering their goals for the following year. See the tables below for an illustration:

Paper Version of Attachment 4 from 1820-0662

Baseline Data	Long-term Goal	Short-term goal	Annual Progress toward Short Term Goal	Submit to RSA
State calculates and enters	State determines goal and enters	State determines goal and enters	State calculates and enters	On paper

Vs.

Online Version of Attachment 4 from 1820-0662

Baseline Data	Long-term Goal	Short-term goal	Annual Progress toward Short Term Goal	Submit to RSA
Automatically calculated and transferred from 1820-0572	State determines goal and enters	State determines goal and enters	Automatically calculated and transferred from 1820-0572	Automatically submitted to RSA by system

To make the proposed online Attachment 4 even easier for Grantees to use, RSA also proposes that the web page supporting it be located adjacent to the web page for the online 1820-0572. This would enable grantees to complete Attachment 4 online right after entering their raw data without having to log out of the system and log onto a new web page. A related 83-C for 1820-0572 will follow.