Burden Spreadsheet

Respondent Category	Type of respondents	Instruments	Form	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burden
State Government	State Program Staff	Review of SUA	N/A	53	1	53	10	530	$20.69	$10,965.70
State Government	State Program Staff	Review of Self-Employment Methodology	N/A	21	1	21	10	210	$20.69	$4,344.90
SA Reporting Subtotal				53		74		740		$15,310.60
State Government	State Program Staff	Recordkeeping	N/A	53	1	53	0.1169	6	$20.69	$128.19
Grand Total Reporting and recordkeeping				53		127		746		$15,438.79
Total Cost (Subtotal x 50% Federal Share of Costs)										$7,719