Change Justification

PAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency

OMB Control Number

US Department of Education / Office of Elementary and Secondary Education

Enter only items that change
Current Record

1810-0743

New Record

Agency form number(s)

Annual reporting and record keeping
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 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** - This change is to correct an error in the directions for this collection.
Original Directions:
After one year, an SEA must return to the Department any funds that it did not reserve for administration (up to 1% of its
total ESSER award) or that have not been otherwise awarded.
Revised Directions:
After one year, an SEA must return to the Department any funds that it did not reserve for administration (up to ½ of 1% of
its total ESSER award) or that have not been otherwise awarded.
Signature of Senior Officer or
designee:

Date:

For OIRA Use
6/19/2020

**This form cannot be used to extend an expiration date
OMB 83-C