Burden estimate

Burden Computation - Business Forms
Page 1 of 1

November 14, 2013

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

8453-R/
Declaration and Signature for Electronic Filing of Forms 8947 and 8963
2013

Changes (+ -)

2013

1,100
______________
5
______________
0.00
______________
0.85
______________
2
______________

+1,450
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,550
______________
5
______________
0.00
______________
0.85
______________
2
______________

Computation of Changes
2,550 x _____________
1.62
Old Computation (Prog. Change) ______________
2,550
1.62
New Computation.............. ______________ x _____________
Balance...

=
=

4,131
_______________
4,131
_______________
_______________
0

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

1,100 x _____________
1.62
______________
______________
2,550 x _____________
1.62

=
=

1,782
_______________
_______________
4,131
_______________
+2,349

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

Summary
1,782
_______________
0
_______________
+2,349
_______________
4,131
_______________

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

Paperwork Reduction Act Notice
Time Per Response
1.62
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
1.20
______________
0.20
______________
0.22
______________
0.00
______________

Average Time
Per Response
1 hrs. , 12 min.
___________________
0 hrs. , 12 min.
___________________
0 hrs. , 13 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
Increase in population estimate per ACA group comments to FRN.