Payment Voucher for Filing Fee Under Section 170(f)(13)

Burden Computation - Individual Forms
Page 1 of 1

October 16, 2016

Product:
Description:
Variables
Responses.......
Line Items......
Pages...........
Words...........
Code References.
Income Records..
Other Records...
Avg Lines used..

8283-V/
Payment Voucher for Filing Fee Under Section 170(f)(13)
2014

Changes (+ -)

2016

500
______________
9
______________
0.25
______________
755.00
______________
2
______________
0.00
______________
0.00
______________
0.85
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

500
______________
9
______________
0.25
______________
755.00
______________
2
______________
0.00
______________
0.00
______________
0.85
______________

Computation of Changes
500 x _____________
0.81
Old Computation (Prog. Change) ______________
500 x _____________
0.81
New Computation.............. ______________
Balance...

=
=

405
_______________
405
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

405
_______________
0
_______________
_______________
405
_______________

Paperwork Reduction Act Notice
Time Per Response
0.81
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.00
______________
0.41
______________
0.23
______________
0.17
______________

0 hrs. , 00 min.
___________________
0 hrs. , 24 min.
___________________
0 hrs. , 13 min.
___________________
0 hrs. , 10 min.
___________________