5300 Burden

Burden Computation - Business Forms
Page 1 of 1

October 15, 2007

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

5300/
Application for Determination for Employee Benefit Plan (Info Copy Only)
2004

Changes (+ -)

2007

85,000
______________
172
______________
5.00
______________
0.85
______________
62
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

85,000
______________
172
______________
5.00
______________
0.85
______________
62
______________

Computation of Changes
85,000 x _____________
64.15
Old Computation (Prog. Change) ______________
85,000
64.15
New Computation.............. ______________ x _____________
Balance...

=
=

5,452,750
_______________
5,452,750
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

5,452,750
_______________
0
_______________
_______________
5,452,750
_______________

Paperwork Reduction Act Notice
Time Per Response
64.15
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
41.13
______________
8.00
______________
13.68
______________
1.34
______________

Average Time
Per Response
41 hrs. , 07 min.
___________________
8 hrs. , 00 min.
___________________
13 hrs. , 40 min.
___________________
1 hrs. , 20 min.
___________________