| 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. | ||||||||||||||||
| Importation of Pork-filled Pasta | 0579-0214 | |||||||||||||||||
| DATE PREPARED | ||||||||||||||||||
| December 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) | ||||||||
| 94.12 | Official Certificate - Foreign Federal Government | 1 | 1 | 1 | .25 | 1 | ||||||||||||
| 94.12 | Recordkeeping | 1 | 1 | 1.0000 | ||||||||||||||
| 94.12 | Cooperative Service Agreement | 1 | 1 | 1 | .016 | 1 | ||||||||||||
| 1.00 | ||||||||||||||||||
| TOTAL OF ALL PAGES | 2.00 | 2.00 | 1.00 | 1.00 | ||||||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 3.00 | 3.00 | ||||||||||||||||
| 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. | ||||||||||||||||
| 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 | Khbrown |
| File Modified | 2009-07-09 |
| File Created | 2000-01-10 |