Burden Computation

Burden Computation - Business Forms
Page 1 of 1

November 16, 2007

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

4136/
Credit For Federal Tax Paid On Fuels
2006

Changes (+ -)

2007

1,219,173
______________
20
______________
0.00
______________
0.85
______________
1
______________

_____________________________
-18
_____________________________
_____________________________
_____________________________
_____________________________

1,219,173
______________
2
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
1,219,173 x _____________
5.06
Old Computation (Prog. Change) ______________
1,219,173
0.69
New Computation.............. ______________ x _____________
Balance...

=
=

6,169,016
_______________
841,230
_______________
_______________
-5,327,786

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

6,169,016
_______________
-5,327,786
_______________
_______________
841,230
_______________

Paperwork Reduction Act Notice
Time Per Response
0.69
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
0.48
______________
0.10
______________
0.11
______________
0.00
______________

Average Time
Per Response
0 hrs. , 28 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
Added 1 Code Reference and deleted 18 lines.

Correction to prior line count.

Burden Computation - Business Forms
Page 1 of 1

November 16, 2007

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

4136/LINE 1

2006

Changes (+ -)

2007

210,146
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

210,146
______________
7
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
210,146 x _____________
1.70
Old Computation (Prog. Change) ______________
210,146
1.70
New Computation.............. ______________ x _____________
Balance...

=
=

357,249
_______________
357,249
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

357,249
_______________
0
_______________
_______________
357,249
_______________

Paperwork Reduction Act Notice
Time Per Response
1.70
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No changes.

Average Hours
Per Response
1.67
______________
0.00
______________
0.03
______________
0.00
______________

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 16, 2007

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

4136/LINE 2

2006

Changes (+ -)

2007

2,686
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,686
______________
7
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
2,686 x _____________
1.70
Old Computation (Prog. Change) ______________
2,686
1.70
New Computation.............. ______________ x _____________
Balance...

=
=

4,567
_______________
4,567
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

4,567
_______________
0
_______________
_______________
4,567
_______________

Paperwork Reduction Act Notice
Time Per Response
1.70
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No Changes.

Average Hours
Per Response
1.67
______________
0.00
______________
0.03
______________
0.00
______________

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 16, 2007

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

4136/LINE 3

2006

Changes (+ -)

2007

25,375
______________
11
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

25,375
______________
11
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
25,375 x _____________
2.67
Old Computation (Prog. Change) ______________
25,375
2.67
New Computation.............. ______________ x _____________
Balance...

=
=

67,752
_______________
67,752
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

67,752
_______________
0
_______________
_______________
67,752
_______________

Paperwork Reduction Act Notice
Time Per Response
2.67
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No changes.

Average Hours
Per Response
2.63
______________
0.00
______________
0.04
______________
0.00
______________

Average Time
Per Response
2 hrs. , 37 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 02 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/LINE 4

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

2006

Changes (+ -)

2007

718,479
______________
9
______________
0.00
______________
0.85
______________
0
______________

_____________________________
+6
_____________________________
_____________________________
_____________________________
_____________________________

718,479
______________
15
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
718,479 x _____________
2.19
Old Computation (Prog. Change) ______________
718,479
3.65
New Computation.............. ______________ x _____________
Balance...

=
=

1,573,470
_______________
2,622,449
_______________
_______________
+1,048,979

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,573,470
_______________
+1,048,979
_______________
_______________
2,622,449
_______________

Paperwork Reduction Act Notice
Time Per Response
3.65
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Added 6 lines.

Average Hours
Per Response
3.59
______________
0.00
______________
0.06
______________
0.00
______________

Average Time
Per Response
3 hrs. , 35 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 03 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/LINE 5

2006

Changes (+ -)

2007

14,217
______________
8
______________
0.00
______________
0.85
______________
0
______________

_____________________________
+2
_____________________________
_____________________________
_____________________________
+1
_____________________________

14,217
______________
10
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
14,217 x _____________
1.94
Old Computation (Prog. Change) ______________
14,217
2.63
New Computation.............. ______________ x _____________
Balance...

=
=

27,581
_______________
37,391
_______________
_______________
+9,810

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

27,581
_______________
+9,810
_______________
_______________
37,391
_______________

Paperwork Reduction Act Notice
Time Per Response
2.63
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
2.39
______________
0.10
______________
0.14
______________
0.00
______________

Notes:
Added 1 Code reference and 2 lines.

Average Time
Per Response
2 hrs. , 23 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 08 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/LINE 6

2006

Changes (+ -)

2007

8,065
______________
6
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

8,065
______________
6
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
8,065 x _____________
1.46
Old Computation (Prog. Change) ______________
8,065
1.46
New Computation.............. ______________ x _____________
Balance...

=
=

11,775
_______________
11,775
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

11,775
_______________
0
_______________
_______________
11,775
_______________

Paperwork Reduction Act Notice
Time Per Response
1.46
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No Changes.

Average Hours
Per Response
1.43
______________
0.00
______________
0.02
______________
0.00
______________

Average Time
Per Response
1 hrs. , 25 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/LINE 7

2006

Changes (+ -)

2007

239,493
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

239,493
______________
7
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
239,493 x _____________
1.70
Old Computation (Prog. Change) ______________
239,493
1.70
New Computation.............. ______________ x _____________
Balance...

=
=

407,139
_______________
407,139
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

407,139
_______________
0
_______________
_______________
407,139
_______________

Paperwork Reduction Act Notice
Time Per Response
1.70
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No Changes.

Average Hours
Per Response
1.67
______________
0.00
______________
0.03
______________
0.00
______________

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/LINE 8

2006

Changes (+ -)

2007

431
______________
13
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

431
______________
13
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
431 x _____________
3.16
Old Computation (Prog. Change) ______________
431
3.16
New Computation.............. ______________ x _____________
Balance...

=
=

1,362
_______________
1,362
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,362
_______________
0
_______________
_______________
1,362
_______________

Paperwork Reduction Act Notice
Time Per Response
3.16
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No Changes.

Average Hours
Per Response
3.11
______________
0.00
______________
0.05
______________
0.00
______________

Average Time
Per Response
3 hrs. , 06 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 03 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/LINE 9

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

2006

Changes (+ -)

2007

277
______________
9
______________
0.00
______________
0.85
______________
0
______________

_____________________________
-4
_____________________________
_____________________________
_____________________________
_____________________________

277
______________
5
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
277 x _____________
2.19
Old Computation (Prog. Change) ______________
277
1.22
New Computation.............. ______________ x _____________
Balance...

=
=

607
_______________
338
_______________
_______________
-269

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

607
_______________
-269
_______________
_______________
338
_______________

Paperwork Reduction Act Notice
Time Per Response
1.22
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted 4 lines.

Average Hours
Per Response
1.20
______________
0.00
______________
0.02
______________
0.00
______________

Average Time
Per Response
1 hrs. , 12 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/LINE 10

2006

Changes (+ -)

2007

143
______________
4
______________
0.00
______________
0.85
______________
0
______________

_____________________________
+3
_____________________________
_____________________________
_____________________________
+3
_____________________________

143
______________
7
______________
0.00
______________
0.85
______________
3
______________

Computation of Changes
143 x _____________
0.97
Old Computation (Prog. Change) ______________
143
2.31
New Computation.............. ______________ x _____________
Balance...

=
=

139
_______________
331
_______________
_______________
+192

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

139
_______________
+192
_______________
_______________
331
_______________

Paperwork Reduction Act Notice
Time Per Response
2.31
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
1.67
______________
0.30
______________
0.34
______________
0.00
______________

Notes:
Added 3 Code references and 3 lines.

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 18 min.
___________________
0 hrs. , 20 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/LINE 11

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

2006

Changes (+ -)

2007

2,000
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
+14
_____________________________
_____________________________
_____________________________
_____________________________

2,000
______________
21
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
2,000 x _____________
1.70
Old Computation (Prog. Change) ______________
2,000
5.10
New Computation.............. ______________ x _____________
Balance...

=
=

3,400
_______________
10,200
_______________
_______________
+6,800

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

3,400
_______________
+6,800
_______________
_______________
10,200
_______________

Paperwork Reduction Act Notice
Time Per Response
5.10
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Added 14 lines.

Average Hours
Per Response
5.02
______________
0.00
______________
0.08
______________
0.00
______________

Average Time
Per Response
5 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 04 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 12

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

2006

Changes (+ -)

2007

233
______________
5
______________
0.00
______________
0.85
______________
0
______________

_____________________________
+10
_____________________________
_____________________________
_____________________________
_____________________________

233
______________
15
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
233 x _____________
1.22
Old Computation (Prog. Change) ______________
233
3.65
New Computation.............. ______________ x _____________
Balance...

=
=

285
_______________
851
_______________
_______________
+566

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

285
_______________
+566
_______________
_______________
851
_______________

Paperwork Reduction Act Notice
Time Per Response
3.65
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Added 10 lines.

Average Hours
Per Response
3.59
______________
0.00
______________
0.06
______________
0.00
______________

Average Time
Per Response
3 hrs. , 35 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 03 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/Line 13

2006

Changes (+ -)

2007

433
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

433
______________
7
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
433 x _____________
1.70
Old Computation (Prog. Change) ______________
433
1.70
New Computation.............. ______________ x _____________
Balance...

=
=

737
_______________
737
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

737
_______________
0
_______________
_______________
737
_______________

Paperwork Reduction Act Notice
Time Per Response
1.70
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No changes.

Average Hours
Per Response
1.67
______________
0.00
______________
0.03
______________
0.00
______________

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 14

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

2006

Changes (+ -)

2007

467
______________
21
______________
0.00
______________
0.85
______________
0
______________

_____________________________
-17
_____________________________
_____________________________
_____________________________
_____________________________

467
______________
4
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
467 x _____________
5.10
Old Computation (Prog. Change) ______________
467
0.97
New Computation.............. ______________ x _____________
Balance...

=
=

2,382
_______________
453
_______________
_______________
-1,929

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,382
_______________
-1,929
_______________
_______________
453
_______________

Paperwork Reduction Act Notice
Time Per Response
0.97
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted 17 lines.

Average Hours
Per Response
0.96
______________
0.00
______________
0.02
______________
0.00
______________

Average Time
Per Response
0 hrs. , 57 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 15

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

2006

Changes (+ -)

2007

200
______________
15
______________
0.00
______________
0.85
______________
0
______________

_____________________________
-12
_____________________________
_____________________________
_____________________________
_____________________________

200
______________
3
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
200 x _____________
3.65
Old Computation (Prog. Change) ______________
200
0.73
New Computation.............. ______________ x _____________
Balance...

=
=

730
_______________
146
_______________
_______________
-584

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

730
_______________
-584
_______________
_______________
146
_______________

Paperwork Reduction Act Notice
Time Per Response
0.73
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted 12 lines.

Average Hours
Per Response
0.72
______________
0.00
______________
0.01
______________
0.00
______________

Average Time
Per Response
0 hrs. , 43 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

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

4136/Line 16

2006

Changes (+ -)

2007

33
______________
11
______________
0.00
______________
0.85
______________
0
______________

_____________________________
-7
_____________________________
_____________________________
_____________________________
+1
_____________________________

33
______________
4
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
33 x _____________
2.67
Old Computation (Prog. Change) ______________
33
1.18
New Computation.............. ______________ x _____________
Balance...

=
=

89
_______________
39
_______________
_______________
-50

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

89
_______________
-50
_______________
_______________
39
_______________

Paperwork Reduction Act Notice
Time Per Response
1.18
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
0.96
______________
0.10
______________
0.12
______________
0.00
______________

Notes:
Added 1 Code Reference and deleted 7 lines.

Average Time
Per Response
0 hrs. , 57 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 07 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 17

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

2006

Changes (+ -)

2007

7
______________
4
______________
0.00
______________
0.85
______________
0
______________

_____________________________
-2
_____________________________
_____________________________
_____________________________
_____________________________

7
______________
2
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
7 x _____________
0.97
Old Computation (Prog. Change) ______________
7
0.49
New Computation.............. ______________ x _____________
Balance...

=
=

7
_______________
4
_______________
_______________
-3

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

7
_______________
-3
_______________
_______________
4
_______________

Paperwork Reduction Act Notice
Time Per Response
0.49
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted 2 lines.

Average Hours
Per Response
0.48
______________
0.00
______________
0.01
______________
0.00
______________

Average Time
Per Response
0 hrs. , 28 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 18

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

2006

Changes (+ -)

2007

7
______________
3
______________
0.00
______________
0.85
______________
0
______________

-7
_____________________________
-3
_____________________________
_____________________________
-0.85
_____________________________
_____________________________

0
______________
0
______________
0.00
______________
0.00
______________
0
______________

Computation of Changes
0 x _____________
0.73
Old Computation (Prog. Change) ______________
0
0.00
New Computation.............. ______________ x _____________
Balance...

=
=

0
_______________
0
_______________
_______________
0

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

7 x _____________
0.73
______________
______________
0 x _____________
0.73

=
=

6
_______________
_______________
0
_______________
-6

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

6
_______________
0
_______________
-6
_______________
0
_______________

Paperwork Reduction Act Notice
Time Per Response
0.00
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted Section.

Average Hours
Per Response
0.00
______________
0.00
______________
0.00
______________
0.00
______________

Average Time
Per Response
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 19

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

2006

Changes (+ -)

2007

67
______________
5
______________
0.00
______________
0.85
______________
0
______________

-67
_____________________________
-5
_____________________________
_____________________________
-0.85
_____________________________
_____________________________

0
______________
0
______________
0.00
______________
0.00
______________
0
______________

Computation of Changes
0 x _____________
1.22
Old Computation (Prog. Change) ______________
0
0.00
New Computation.............. ______________ x _____________
Balance...

=
=

0
_______________
0
_______________
_______________
0

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

67 x _____________
1.22
______________
______________
0 x _____________
1.22

=
=

82
_______________
_______________
0
_______________
-82

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

82
_______________
0
_______________
-82
_______________
0
_______________

Paperwork Reduction Act Notice
Time Per Response
0.00
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted section.

Average Hours
Per Response
0.00
______________
0.00
______________
0.00
______________
0.00
______________

Average Time
Per Response
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

November 21, 2007

Product:
Description:

4136/Line 20

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

2006

Changes (+ -)

2007

660,290
______________
5
______________
0.00
______________
0.85
______________
0
______________

-660,290
_____________________________
-5
_____________________________
_____________________________
-0.85
_____________________________
_____________________________

0
______________
0
______________
0.00
______________
0.00
______________
0
______________

Computation of Changes
0 x _____________
1.22
Old Computation (Prog. Change) ______________
0
0.00
New Computation.............. ______________ x _____________
Balance...

=
=

0
_______________
0
_______________
_______________
0

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

660,290 x _____________
1.22
______________
______________
0 x _____________
1.22

=
=

805,554
_______________
_______________
0
_______________
-805,554

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

805,554
_______________
0
_______________
-805,554
_______________
0
_______________

Paperwork Reduction Act Notice
Time Per Response
0.00
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
Deleted section.

Average Hours
Per Response
0.00
______________
0.00
______________
0.00
______________
0.00
______________

Average Time
Per Response
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 00 min.
___________________