Burden for Schedule D (941)

Burden Computation - Business Forms
Page 1 of 1

September 17, 2013

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

941 (SCH D)/
Report of Discrepancies Caused by Acquisitions, Statutory Mergers, or
2010

Changes (+ -)

2013

10,000
______________
49
______________
0.00
______________
0.85
______________
3
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

10,000
______________
49
______________
0.00
______________
0.85
______________
3
______________

Computation of Changes
10,000 x _____________
12.52
Old Computation (Prog. Change) ______________
10,000
12.52
New Computation.............. ______________ x _____________
Balance...

=
=

125,200
_______________
125,200
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

125,200
_______________
0
_______________
_______________
125,200
_______________

Paperwork Reduction Act Notice
Time Per Response
12.52
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
11.72
______________
0.30
______________
0.50
______________
0.00
______________

Average Time
Per Response
11 hrs. , 43 min.
___________________
0 hrs. , 18 min.
___________________
0 hrs. , 30 min.
___________________
0 hrs. , 00 min.
___________________