Appendix K WIC and FMNP Waiver Requests Burden Table

Appendix K - Waivers and State Plans (WiSP) Burden Table
Waivers and State Plans (WiSP) Burden Table
Instrument	Statutory & Regulatory Citation	Form(s)	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burden
WAIVER AND STATE PLAN APPLICATION BURDEN ESTIMATES
REPORTING ESTIMATES
Affected Public: State sgencies (including Indian Tribal Organizations and U.S. Territories)
ANNUAL STATE PLAN SUBMISSION	246.4 -WIC 248.4 - FMNP 249.4 - SFMNP		194.00	1.00	194.00	80.00	15,520.00	$34.89	$541,492.80
IMPORT OF STATE PLAN SUPPLEMENTAL DOCUMENTS	246.4 - WIC 248.4 - FMNP 249.4 - SFMNP		194.00	1.00	194.00	5.00	970.00	$34.89	$33,843.30
STATE PLAN AMENDMENTS	246.4(c) - WIC 248.4(b) - FMNP 249.4(b) - SFMNP		194.00	1.50	291.00	2.00	582.00	$34.89	$20,305.98
WAIVER DATA GATHERING	246.29 - WIC 42 U.S.C. 1786 - FMNP 42 U.S.C. 5121 - SFMNP		20.00	1.50	30.00	3.00	90.00	$34.89	$3,140.10
STANDARD WAIVER SUBMISSION	246.29 - WIC 42 U.S.C. 1786 - FMNP 42 U.S.C. 5121 - SFMNP		20.00	1.50	30.00	3.00	90.00	$34.89	$3,140.10
APPLICATION TRAINING	246.4, 246.29 - WIC 248.4, 42 U.S.C. 1786 - FMNP 249.4, 42 U.S.C. 5121 - SFMNP		194.00	1.00	194.00	6.00	1,164.00	$34.89	$40,611.96
GRAND SUBTOTAL: REPORTING			194.00	4.81	933.00	19.74	18,416.00	$34.89	$642,534.24
RECORDKEEPING ESTIMATES
Affected Public: State sgencies (including Indian Tribal Organizations and U.S. Territories)
STATE PLAN RECORKEEPING	246.4(d) - WIC 248.4(c) - FMNP 249.4(c) - SFMNP		194.00	1.00	194.00	2.00	388.00	$34.89	$13,537.32
WAIVER RECORDKEEPING	246.29 - WIC 42 U.S.C. 1786 - FMNP 42 U.S.C. 5121 - SFMNP		20.00	1.00	20.00	2.00	40.00	$34.89	$1,395.60
GRAND SUBTOTAL: RECORDKEEPING			194.00	1.10	214.00	2.00	428.00	$34.89	$14,932.92
GRAND TOTAL: REPORTING AND RECORDKEEPING			194.00	5.91	1147.00	16.43	18,844.00	$34.89	$657,467.16