Form 1128 (Parts I & II) Burden

Burden Computation - Business Forms
Page 1 of 1

May 1, 2007

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

1128/PARTS I & II

2005

Changes (+ -)

2007

7,788
______________
35
______________
0.00
______________
0.85
______________
59
______________

_____________________________
+1
_____________________________
_____________________________
_____________________________
_____________________________

7,788
______________
36
______________
0.00
______________
0.85
______________
59
______________

Computation of Changes
7,788 x _____________
20.48
Old Computation (Prog. Change) ______________
7,788
20.73
New Computation.............. ______________ x _____________
Balance...

=
=

159,499
_______________
161,446
_______________
_______________
+1,947

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

159,499
_______________
+1,947
_______________
_______________
161,446
_______________

Paperwork Reduction Act Notice
Time Per Response
20.73
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
8.61
______________
5.86
______________
6.26
______________
0.00
______________

Notes:
Form revised. Added 1 line item.

Average Time
Per Response
8 hrs. , 36 min.
___________________
5 hrs. , 51 min.
___________________
6 hrs. , 15 min.
___________________
0 hrs. , 00 min.
___________________