83C Justification Worksheet

PAPERWORK REDUCTION ACT

CHANGE WORKSHEET

Agency/subagency

OMB Control Number

U.S Department of Education
1845

Enter only items that change
Current record

Agency form number (s)

-

0167

New record

Debt Relief Application Form
Spanish with 1845-0167
Online & Paper
Annual reporting and recordkeeping hour
burden
Number of respondents
Total annual responses

38,237,500

Percent of these responses
collected electronically
Total annual hours

96.5

%

%

8,236,075

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)
Total annualized cost requested
Difference
Explanation of difference
Program change
Adjustment
Other changes
This request is to include the attached versions of the Debt Relief Application Form - Spanish (online and paper versions) in the emergency clearance
for the Federal Student Loan Debt Relief Application and Verification Forms Request, OMB Control Number 1845-0167. There are no changes to the
number of respondents/responses/burden hours in the currently approved collection.

Signature of Senior Official or designee:

Beth Grebeldinger

Digitally signed by Beth Grebeldinger
Date: 2022.10.11 08:29:17 -04'00'

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

OMB 83-C

Date:

10-11-2022

For OIRA Use
___________________________________
___________________________________

10/95