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pdfPAPERWORK REDUCTION ACT
CHANGE WORKSHEET
Agency/Subagency
OMB control number
DHS/TSA
1
6
5
2
0
0
2
7
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**
Pursuant to Executive Order 14168, TSA has updated the online website to replace the term “gender” with the term “sex” and to remove the third
option, showing only the options “male” and “female.”
Signature of Senior Official or designee:
Date:
For OIRA Use
2.24.2025
**This form cannot be used to extend an expiration date.
OMB FORM 83-C, 10/95
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Adobe Professional 7.0
| File Type | application/pdf |
| File Title | OMB Form 83-C, Paperwork Reduction Act Change Worksheet, October 1995 |
| Author | WHS/ESD/IMD |
| File Modified | 2025-02-24 |
| File Created | 2007-08-09 |