Sch 5 (F8849) Burden

Burden Computation - Business Forms
Page 1 of 1

September 10, 2007

Product:
Description:

8849 (SCH 5)/
Section 4081(e) Claims

Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

2006

Changes (+ -)

2007

1,000
______________
15
______________
0.00
______________
0.85
______________
1
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,000
______________
15
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
1,000 x _____________
3.85
Old Computation (Prog. Change) ______________
1,000
3.85
New Computation.............. ______________ x _____________
Balance...

=
=

3,850
_______________
3,850
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

3,850
_______________
0
_______________
_______________
3,850
_______________

Paperwork Reduction Act Notice
Time Per Response
3.85
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No changes made.

Average Hours
Per Response
3.59
______________
0.10
______________
0.16
______________
0.00
______________

Average Time
Per Response
3 hrs. , 35 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 09 min.
___________________
0 hrs. , 00 min.
___________________