Worksheet A burden

Burden Computation - Individual Forms
Page 1 of 1

April 24, 2007

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

1116/Worksheet A

2005

Changes (+ -)

2007

100,651
______________
9
______________
0.00
______________
334.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

100,651
______________
9
______________
0.00
______________
334.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

Computation of Changes
100,651 x _____________
0.35
Old Computation (Prog. Change) ______________
100,651 x _____________
0.35
New Computation.............. ______________
Balance...

=
=

35,228
_______________
35,228
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

35,228
_______________
0
_______________
_______________
35,228
_______________

Paperwork Reduction Act Notice
Time Per Response
0.35
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
0.00
______________
0.03
______________
0.21
______________
0.11
______________

0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 12 min.
___________________
0 hrs. , 06 min.
___________________