Burden

Burden Computation - Special Business Forms
Page 1 of 1

February 2, 2012

Product:
Description:
Variables
Responses.......
Line Items......
Forms Prepared..

5498ESA/
Coverdell ESA Contribution Information
2009

Changes (+ -)

2012

150,000
______________
8
______________
0.85
______________

_____________________________
_____________________________
_____________________________

150,000
______________
8
______________
0.85
______________

Computation of Changes
150,000 x _____________
0.12
Old Computation (Prog. Change) ______________
150,000 x _____________
0.12
New Computation.............. ______________
Balance...

=
=

18,000
_______________
18,000
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

18,000
_______________
0
_______________
_______________
18,000
_______________

Paperwork Reduction Act Notice
Time Per Response
0.12
Record Keeping............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
______________
______________
______________
0.12
______________

Average Time
Per Response
___________________
___________________
___________________
0 hrs. , 07 min.
___________________