Burden for Worksheets

burden_for_worksheets_of_Form_8941.pdf

Employee health insurance expenses of small employers

Burden for Worksheets

OMB: 1545-2198

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Burden Computation - Business Forms
Page 1 of 1

May 16, 2014

Product:
Description:

8941/Worksheets 1-7.

Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

______________
______________
______________
______________
______________

Changes (+ -)

2010

+1,523,482
_____________________________
+50
_____________________________
_____________________________
+0.04
_____________________________
_____________________________

1,523,482
______________
50
______________
0.00
______________
0.04
______________
0
______________

Computation of Changes
1,523,482 x _____________
Old Computation (Prog. Change) ______________
1,523,482 x _____________
7.58
New Computation.............. ______________
Balance...

=
=

_______________
11,547,994
_______________
_______________
+11,547,994

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+11,547,994
_______________
_______________
11,547,994
_______________

Paperwork Reduction Act Notice
Time Per Response
7.58
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
6.33
______________
0.00
______________
1.25
______________
0.00
______________

Average Time
Per Response
6 hrs. , 19 min.
___________________
0 hrs. , 00 min.
___________________
1 hrs. , 15 min.
___________________
0 hrs. , 00 min.
___________________


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