Worksheet B 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 B

2005

Changes (+ -)

2007

100,651
______________
5
______________
0.00
______________
223.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

100,651
______________
5
______________
0.00
______________
223.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

Computation of Changes
100,651 x _____________
0.25
Old Computation (Prog. Change) ______________
100,651 x _____________
0.25
New Computation.............. ______________
Balance...

=
=

25,163
_______________
25,163
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

25,163
_______________
0
_______________
_______________
25,163
_______________

Paperwork Reduction Act Notice
Time Per Response
0.25
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
0.00
______________
0.02
______________
0.12
______________
0.11
______________

0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 07 min.
___________________
0 hrs. , 06 min.
___________________