| 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. | ||||||||||||
| Bees and Related Articles | 0579-0207 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| November 22, 2017 | ||||||||||||||
| 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) | ||||
| 322.2(c )(1), 322.3 | Cost and Charges Bill for Confiscated Articles (business) | None | 1 | 1.00 | 1 | 0.50 | 1 | 0 | ||||||
| 322.6, 23, 30 | Documentation for Transit Shipments - Export Certificate (business) | None | 5 | 3.00 | 15 | 0.25 | 4 | 0 | ||||||
| 322.6, 23, 30 | Documentation for Transit Shipments - Export Certificate (foreign gov't) | None | 2 | 7.00 | 14 | 0.25 | 4 | 0 | ||||||
| 322.7 (a) | Notice of Arrival for Shipments from Approved Regions (business) (same) | None | 5 | 3.00 | 15 | 0.15 | 2 | 0 | ||||||
| 322.9, | Labeling of Shipments from Approved Regions (business-3rd party disclosure) (same) | None | 5 | 3.00 | 15 | 0.10 | 2 | 0 | ||||||
| 322.9, 14 | Invoice Packing List (business) (same) | None | 5 | 3.00 | 15 | 0.15 | 2 | 0 | ||||||
| SUBTOTAL | 8 | 75 | 15 | 0 | 0 | |||||||||
| TOTAL OF ALL PAGES | 18 | 208 | 48 | 2 | 2 | |||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 210 | 50 | ||||||||||||
| 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. | ||||||||||||
| Bees and Related Articles | 0579-0207 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| November 15, 2017 | ||||||||||||||
| 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) | ||||
| 322.10 & 19 | Port of entry Inspections (business) (same) | None | 5 | 3.00 | 15 | 0.25 | 4 | 0 | ||||||
| 322.12 | Request for Risk Assessment (foreign gov't) (same) (NOTE/Corrected: Documented as Farms/ Business in the last renewal) | None | 1 | 1.00 | 1 | 8.00 | 8 | 0 | ||||||
| 322.13(b) | Federal, State, and Researcher Verification (State) | None | 4 | 1.00 | 4 | 0.15 | 1 | 0 | ||||||
| 322.13(b) | Federal, State, and Researcher Verification (business) | None | 6 | 1.00 | 6 | 0.15 | 1 | 0 | ||||||
| 322.14 | Application for a permit to import a restricted Organism - (State) (same) | PPQ 526 | 6 | 1.00 | 6 | 0.17 | 1 | 0 | ||||||
| 322.14 | Application for a Permit to Import a Restricted Organism (business) (same) | PPQ 526 | 4 | 1.00 | 4 | 0.17 | 1 | 0 | ||||||
| SUBTOTAL | 10 | 36 | 16 | 0 | 0 | |||||||||
| 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. | ||||||||||||
| Bees and Related Articles | 0579-0207 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| November 15, 2017 | ||||||||||||||
| 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) | ||||
| 322.15 | State Consultation and Approval of Permit Application (State) (same) | None | 4 | 3.00 | 12 | 0.15 | 2 | 0.00 | ||||||
| 322.15(b)(1) | Written Agreement to Permit Conditions (business) (same) | None | 5 | 3.0000 | 15 | 0.1500 | 2 | 0.00 | ||||||
| 322.15(e ) | Appeal/Withdrawal of Denied/Revoked Permit (business) (same) | Letter | 1 | 1.0000 | 1 | 0.5000 | 1 | 0.00 | ||||||
| 322.17(a) | Special Mailing Label (business) (same) | APHIS 599 | 10 | 2.0000 | 20 | 0.0016 | 1 | 0.00 | ||||||
| 322.17, 18, 19, 34 | Emergency Action Notification (business) (same) | PPQ 523 | 1 | 1.0000 | 1 | 1.0000 | 1 | 0.00 | ||||||
| 322.21(b) | Post-entry Inspections of Facilities (business) (same) | None | 1 | 1.0000 | 1 | 1.0000 | 1 | 0.00 | ||||||
| SUBTOTAL | 50 | 8 | 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. | ||||||||||||
| Bees and Related Articles | 0579-0207 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| November 15, 2017 | ||||||||||||||
| 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) | ||||
| 322.21(d)(1) | Request of Release from Containment Facility (business) (same) | Letter | 10 | 2.00 | 20 | 0.15 | 3 | 0 | ||||||
| 322.21 | Recordkeeping for Containment Facilities (business) (same) | None | 0 | 0 | 2 | 1.000 | 2.00 | |||||||
| 322.24 | Packaging of Shipments (business) (same) | None | 5 | 3.00 | 15 | 0.05 | 1 | 0.00 | ||||||
| 322.25 | Notice of Arrival for Transit Shipments (business) (same) | None | 4 | 1.00 | 4 | 0.15 | 1 | 0.00 | ||||||
| 322.31 | Interstate Movement Notice of Arrival for Restricted Articles (business) (same) | None | 4 | 1.00 | 4 | 0.15 | 1 | 0.00 | ||||||
| 322.14(a)(19) | Request for Facility Approval (business) (same) | None | 1 | 1.0000 | 1 | 0.5000 | 1 | 0.00 | ||||||
| SUBTOTAL | 44.00 | 7.00 | 2 | 2.00 | ||||||||||
| 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. | ||||||||||||
| Bees and Related Articles | 0579-0207 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| November 15, 2017 | ||||||||||||||
| 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) | ||||
| 322.21(c )(3) | Notification of Escaped Organism (business) (same) | None | 1 | 1.00 | 1 | 0.15 | 1 | 0.00 | ||||||
| 322.32 | Labeling of Restricted Articles (business-3rd party) (same) | None | 2 | 1.00 | 2 | 0.10 | 1 | 0.00 | ||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0 | ||||||||||||||
| 0.00 | ||||||||||||||
| SUBTOTAL | 3.00 | 2.00 | 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 | |||||||||||||
| 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) | ||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | 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 | |||||||||||||
| 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) | ||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| 0.00 | ||||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | 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 | |||||||||||||
| 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) | ||||
| 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 | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 | |||||||||||||
| 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) | ||||
| 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 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 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 |