Change Justification Form

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

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

0005
1801
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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

34,410

34,460

Total annual responses

34,410

34,460

Percent of these responses
collected electronically
Total annual hours

%
18,015

%
18,265

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**

This request includes changes to the C&A and notice. Grantees who did not receive student aid funding under the CARES Act
or CRRSAA will be eligible to apply for similar funding under the American Rescue Plan Act of 2021. We expect 50 applicants
at 5 hours each, totaling 250 hours. This request also updates the student aid reporting requirements to align with CRRSAA
and ARP.
Signature of Senior Official or designee:
Date:
For OIRA Use
___________________________________
Digitally signed by Lauren Kennedy
___________________________________

Lauren Kennedy

Date: 2021.04.30 10:33:05 -04'00'

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

OMB 83-C

10/95