on line burden

Burden Computation - Individual Forms
Page 1 of 1

September 11, 2013

Product:
Description:
Variables
Responses.......
Line Items......
Pages...........
Words...........
Code References.
Income Records..
Other Records...
Avg Lines used..

8821/On Line

2013

Changes (+ -)

2013

10,000
______________
12
______________
1.00
______________
1,392.00
______________
1
______________
0.00
______________
3.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

10,000
______________
12
______________
1.00
______________
1,392.00
______________
1
______________
0.00
______________
3.00
______________
0.00
______________

Computation of Changes
10,000 x _____________
1.08
Old Computation (Prog. Change) ______________
10,000 x _____________
1.08
New Computation.............. ______________
Balance...

=
=

10,800
_______________
10,800
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

10,800
_______________
0
_______________
_______________
10,800
_______________

Paperwork Reduction Act Notice
Time Per Response
1.08
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.33
______________
0.13
______________
0.28
______________
0.34
______________

0 hrs. , 19 min.
___________________
0 hrs. , 07 min.
___________________
0 hrs. , 16 min.
___________________
0 hrs. , 20 min.
___________________