| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
| Bovine Spongiform Encephalopathy; Importation of Animals and Animal Products | 0579-0234 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | RECORDS | |||||||||||||
| TOTAL | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
| RESPONDENT | KEEPER | |||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
| 95.4 | Import Permit Application (Business) | VS 16-3 | 728 | 1.00 | 728.00 | 0.50 | 364.00 | 0.00 | ||||||
| 95.29 | Certificate for Inedible Processed Ovine/Caprine Origin Materials and Products from from a Region Not Listed in 9 CFR 95.4(a)(4) (Foreign Government) | None | 2,635 | 12.00 | 31,620.00 | 1.00 | 31,620.00 | 0.00 | ||||||
| 95.4 | Cooperative Service Agreement (signature only) (Business) | None | 1 | 1.00 | 1.00 | 0.02 | 1.00 | 0.00 | ||||||
| 95.4 | Certification Statement for Ovine/Caprine Products from Regions Listed in 9 CFR 95.4(a)(4) and for Inedible Processed Animal Proteins Derived from Ovines/Caprines (signature only) (Foreign Government) | None | 3,600 | 38.00 | 136,800.00 | 1.00 | 136,800.00 | 0.00 | ||||||
| 93.436 | Seals (Foreign Government) | None | 3,000 | 20.00 | 60,000.00 | 1.00 | 60,000.00 | 0.00 | ||||||
| 93.419 | Notification of Designation of Persons Authorized to Break Seals (Business) | None | 900 | 6.00 | 5,400.00 | 0.25 | 1,350.00 | 0.00 | ||||||
| SUBTOTAL | 234,549.00 | 230,135.00 | 0.00 | 0.00 | ||||||||||
| TOTAL OF ALL PAGES | 235,752.00 | 231,307.00 | 0.00 | 0.00 | ||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 235,752.00 | 231,307.00 | ||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||
| Bovine Spongiform Encephalopathy; Importation of Animals and Animal Products | 0579-0234 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | RECORDS | |||||||||||||
| TOTAL | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||
| RESPONDENT | KEEPER | |||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||
| 93.420 | Agreement with Slaughter Facilities Concerning the Use of Seals on Conveyances Transporting Animals from Canada (Business) | None | 1 | 1.00 | 1.00 | 0.02 | 1.00 | 0.00 | ||||||
| 93.420 | Notification Regarding Conditions of Sealed Shipments (Business) | None | 1 | 1.00 | 1.00 | 0.02 | 1.00 | |||||||
| 93.405, 93.436 | Animals Imported for Immediate Slaughter (Business) (animal owners and slaughtering facilities) | VS 17-33 | 20 | 25.00 | 500.00 | 2.00 | 1,000.00 | 0.00 | ||||||
| 93.436 | Certification Statement for Ruminants (Signature Only) (Foreign Government) | None | 1 | 1.00 | 1.00 | 0.02 | 1.00 | 0.00 | ||||||
| 93.436 | Ruminants Imported to Designated/Approved Feedlots (Business) | VS 17-130 | 20 | 5.00 | 100.00 | 0.19 | 19.00 | 0.00 | ||||||
| 93.436 | Permit for Movement of Restricted Animals (Business) | VS 1-27 | 20 | 30.00 | 600.00 | 0.2500 | 150.00 | 0.00 | ||||||
| SUBTOTAL | 1,203.00 | 1,172.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | |||||||||||||
| OMB NO. | ||||||||||||||
| 0581- | ||||||||||||||
| DATE PREPARED | ||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||
| REPORTS | ||||||||||||||
| RECORDS | ||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | TOTAL | ||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | NO. OF | ANNUAL | RECORD- | ||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | RECORD- | HOURS PER | KEEPING HOURS | ||||||
| RESPONDENT | KEEPERS | RECORD- | (Col. I x J) | |||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | KEEPER | ||||||
| 0.00 | 0.00 | (I) | (J) | (K) | ||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0.00 | |||||||||||
| 0 | 0.00 | |||||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |