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pdfPAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency
OMB control number
Department of Homeland Security
1
6
0
1
0
0
3
1
Enter only items that change
Current record
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
0
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)
0.00
Total annualized cost requested
0.00
0.00
Difference
Explanation of difference
Program change
Adjustment
Other changes**
The instrument is being updated to ensure it is clear as to the whom the attorney requests. "Who does the attorney or legal representative
represent?" The respondent has the option to choose Separated parent or legal guardian, Separated child, or Both. There are no changes burden.
Signature of Senior Official or designee:
Tyrone Huff
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95
Date:
For OIRA Use
06/09/2022
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| File Type | application/pdf |
| File Title | OMB Form 83-C, Paperwork Reduction Act Change Worksheet, October 1995 |
| Author | WHS/ESD/IMD |
| File Modified | 2022-06-09 |
| File Created | 2007-08-09 |