F941-C Burden

Burden Computation - Business Forms
Page 1 of 1

March 10, 2008

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

941C/
Supporting Statement to Correct Information
2005

Changes (+ -)

2008

900,000
______________
37
______________
______________
0.85
______________
1
______________

_____________________________
+3
_____________________________
_____________________________
_____________________________
_____________________________

900,000
______________
40
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
900,000 x _____________
9.20
Old Computation (Prog. Change) ______________
900,000
9.93
New Computation.............. ______________ x _____________
Balance...

=
=

8,280,000
_______________
8,937,000
_______________
_______________
+657,000

Old Computation (Adjustment).
New Computation..............
Balance...

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

Old Computation..............
New Computation..............
Balance...

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

Summary
Old Burden...................................................
Program Change...............................................
Adjustment...................................................
New Burden...................................................

8,280,000
_______________
+657,000
_______________
_______________
8,937,000
_______________

Paperwork Reduction Act Notice
Time Per Response
9.93
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
9.57
______________
0.10
______________
0.26
______________
0.00
______________

Notes:
Form revised, adding 3 line items.

Average Time
Per Response
9 hrs. , 34 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 15 min.
___________________
0 hrs. , 00 min.
___________________