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-I: 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. | ||||||||||||||
Risk Management Education and Community Outreach Partnerships: Request for Applications | 0563-0067 | |||||||||||||||
DATE PREPARED | ||||||||||||||||
July 2, 2012 | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
Number of Applications Received (time to read RFA in Federal Register) Education & Community Outreach Partnerships | None | 220 | 1.00 | 220.00 | 0.75 | 165.00 | 0.00 | $17.22 | $2,841.30 | |||||||
-Targeted States | None | 30 | 1.00 | 30.00 | 0.75 | 22.50 | ||||||||||
Complete Narrative, SOW & Budget Education & Community Outreach Partnerships | None | 220 | 1.00 | 220.00 | 16.00 | 3,520.00 | 0.00 | $20.53 | $72,265.60 | |||||||
- Targeted States | None | 30 | 1.00 | 30.00 | 16.00 | 480.00 | 0.00 | $17.22 | $8,265.60 | |||||||
Subtotal | 500.00 | 4,187.50 | ||||||||||||||
Forms and Burden Approved under other OMB Numbers | 0.00 | 0.00 | 0.00 | $20.53 | $0.00 | |||||||||||
Application for Federal Assistance (4040-0004) | SF-424 | 250 | 1.00 | 250.00 | 1.00 | 250.00 | 0.00 | $17.22 | $4,305.00 | |||||||
Budget Information - Non-Construction Programs (4040-0008) | SF-424A | 250 | 1.00 | 250.00 | 3.00 | 750.00 | 0.00 | $20.53 | $15,397.50 | |||||||
Assurances - Non-Construction Programs (4040-0007) | SF-424B | 250 | 1.00 | 250.00 | 0.25 | 62.50 | 0.00 | $17.22 | $1,076.25 | |||||||
Disclosure of Lobbying Activities (0348-0046) | SF-LLL | 250 | 1.00 | 250.00 | 0.16 | 40.00 | ||||||||||
Certification Regarding Debarment, Suspension, & Other Responsibility Matters | AD-1047 | 250 | 1.00 | 250.00 | 0.33 | 82.50 | 0.00 | $20.53 | $1,693.73 | |||||||
Certification Regarding Drug-Free Workplace Requirements (Grants) | AD-1049 | 250 | 1.00 | 250.00 | 0.33 | 82.50 | 0.00 | $17.22 | $1,420.65 | |||||||
SUBTOTAL | 500.00 | 4,187.50 | 0.00 | 0.00 | $107,265.63 | |||||||||||
TOTAL OF ALL PAGES | 500.00 | 4,187.50 | 0.00 | 0.00 | $107,265.63 | |||||||||||
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 500.00 | 4,187.50 | ||||||||||||||
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||
0581- | ||||||||||||||||
DATE PREPARED | ||||||||||||||||
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||
REPORTS | RECORDS | RESPONDENT COST | ||||||||||||||
TOTAL | ||||||||||||||||
FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | COST | TOTAL | ||||||
SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | PER | COST | ||||
REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | HOUR | (Col. H x L) | ||||||
RESPONDENT | KEEPER | |||||||||||||||
(A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | (L) | (M) | ||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
0.00 | 0.00 | 0.00 | $0.00 | |||||||||||||
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 | 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 | ||||||||||||
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.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |