83-C 1670-0027 Generic

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

DHS\National Protection & Programs Directorate (NPPD)

0027
1670
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___ ___ - ___
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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

14,080

75,080

Total annual responses

14,080

75,080

Percent of these responses
collected electronically
Total annual hours

100

%

7920.3

100

%

9,445.50

Difference

1,525.20

Explanation of difference

The only change to the collection

Program change
Adjustment
Annual reporting and recordkeeping cost
burden (in thousands of dollars)

is to request additional burden hours.

Total annualized Capital/Startup costs
Total annual costs (O&M)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes**

Signature of Senior Official or designee:

EVETTE MAYNARD-NOEL

Digitally signed by EVETTE MAYNARD-NOEL
DN: c=US, o=U.S. Government, ou=Department of Homeland Security, ou=DHS HQ,
ou=People, cn=EVETTE MAYNARD-NOEL,
0.9.2342.19200300.100.1.1=0665116812.DHS HQ
Date: 2016.03.17 13:30:54 -04'00'

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

OMB 83-C

Date:

08/03/2016

For OIRA Use
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10/95