Burden

Burden Computation - Business Forms
Page 1 of 1

December 21, 2006

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

1139/
Corporation Application for Tentative Refund
2004

Changes (+ -)

2006

3,000
______________
115
______________
5.00
______________
0.85
______________
23
______________

_____________________________
+1
_____________________________
_____________________________
_____________________________
+8
_____________________________

3,000
______________
116
______________
5.00
______________
0.85
______________
31
______________

Computation of Changes
3,000 x _____________
42.38
Old Computation (Prog. Change) ______________
3,000
44.25
New Computation.............. ______________ x _____________
Balance...

=
=

127,140
_______________
132,750
_______________
_______________
+5,610

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

127,140
_______________
+5,610
_______________
_______________
132,750
_______________

Paperwork Reduction Act Notice
Time Per Response
44.25
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
27.74
______________
4.92
______________
10.24
______________
1.34
______________

Notes:
Added 1 line item and 8 code references.

Average Time
Per Response
27 hrs. , 44 min.
___________________
4 hrs. , 55 min.
___________________
10 hrs. , 14 min.
___________________
1 hrs. , 20 min.
___________________