INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
Temproary Importation of Competitive and Non competitive Entertainment Horses from Countries Affected with Contagious Equine Metritis | 0579-0324 | |||||||||||||
DATE PREPARED | ||||||||||||||
May 19, 2008 | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
Application for Import Permit (additional information) | 5 | 1.0000 | 5.00 | 4.0000 | 20.00 | 0.00 | ||||||||
93.304 (a) (1)(iii)(B), 93.304 (a) (1)(iii) ( C ) | Permanent Electronic ID, Compatible Reader, | 0.00 | 0.00 | 0.00 | ||||||||||
93.301 (f) (5) (vii), 93.301 (f) (5) (ix), | Photographs for ID, Written Plan for Medical Treatment | 0.00 | 0.00 | 0.00 | ||||||||||
93.304 (a) (1) (iii) (I) | Request to change itinerary or Method of Transportation | 15 | 1.0000 | 15.00 | 0.5000 | 7.50 | 0.00 | |||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 20.00 | 27.50 | 0.00 | 0.00 | ||||||||||
TOTAL OF ALL PAGES | 20.00 | 27.50 | 0.00 | 0.00 | ||||||||||
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 20.00 | 27.50 | ||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
579 | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0579- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
0581- | ||||||||||||||
DATE PREPARED | ||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
REPORTS | RECORDS | |||||||||||||
TOTAL | ||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
RESPONDENT | KEEPER | |||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
0.00 | 0.00 | 0.00 | ||||||||||||
SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 |
File Type | application/vnd.ms-excel |
Author | user |
Last Modified By | kahardy |
File Modified | 2008-05-19 |
File Created | 2000-01-10 |