Aphis 71

APHIS 71.xls

National Animal Identification System

APHIS 71

OMB: 0579-0259

Document [xlsx]
Download: xlsx | pdf
















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.









National Animal Identification System -- Information Requirements for Participants 0579-0259







DATE PREPARED




November 1, 2008

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT











REPORTS RECORDS






















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
N/A Premises Registration (business) [0259] None 100,000 1.0000 100,000.00 1.00 100,000.00

0.00
N/A Updates to premises registration (business) [0259] None 20,000 1.0000 20,000.00 0.50 10,000.00

0.00
N/A Nonproducer Participant Registration (business) [0259] None 25 1.0000 25.00 1.50 37.50 25 1.000 25.00
N/A AIN Device Manufacturer Applications, Agreements, and Training (business) [0283] None 5 1.0000 5.00 12.00 60.00 5 1.000 5.00
N/A Manufacturers' Tags (business)[0283] None 1 1.0000 1.00 12.00 12.00 1 1.000 1.00
N/A Transitional AINs (business)[0283] None 5 2.0000 10.00 0.50 5.00 5 1.000 5.00
N/A Visual Only Eartags (business)[0283] None 1 1.0000 1.00 12.00 12.00 1 1.000 1.00

SUBTOTAL


120,042.00
110,126.50 37.00
37.00

TOTAL OF ALL PAGES


2,154,351.00
1,127,818.75 500,404.00
200,330.20
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c


2,654,755.00
1,328,148.95



















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.









National Animal Identification System -- Information requirements for participants 0579-0259







DATE PREPARED




November 1, 2008

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN









REPORTS RECORDS






















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
N/A RFID Eartags (business) [0283] None 1 1.0000 1.00 12.0000 12.00 1 1.000 1.00
N/A RFID Injectable Transponders (business) [NEW] None 1 1.0000 1.00 12.0000 12.00 1 1.000 1.00
N/A AIN Device Manufacturer Updates and Recordkeeping (business) [NEW] None 8 75.0000 600.00 0.3750 225.00 8 14.000 112.00
N/A AIN Device Managers Registration and Agreement (business) [0283] None 150 1.0000 150.00 0.5000 75.00 150 0.500 75.00
N/A AIN Device Resellers Registration and Agreement (business) [0283] None 200 1.0000 200.00 0.5000 100.00 200 0.500 100.00
N/A AIN Device Managers/Resellers Training (business) [0283] None 350 1.0000 350.00 2.0000 700.00

0.00
N/A AIN Device Managers Updates (business) [NEW] None 150 60.0000 9,000.00 0.5000 4,500.00

0.00

SUBTOTAL


10,302.00
5,624.00 360
289.00
















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.









National Animal Identification System -- Information Requirements for Participants 0579-0259







DATE PREPARED




November 1, 2008

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN









REPORTS RECORDS






















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)

AIN Device Resellers Updates (business)[NEW] None 200 120.0000 24,000.00 0.5000 12,000.00

0.00
N/A Individual and Group/Lot Movement Records (business)[0259] None 500,000 4.0000 2,000,000.00 0.5000 1,000,000.00 500,000 0.400 200,000.00
N/A Application for Evaluation of Anmal Tracking Databse (ATD)(States/Tribes)[0288] None 7 1.0000 7.00 9.7500 68.25

0.00
N/A Cooperative Agreement Forms Family (States/Tribes)[0288] (cleared under 4040-0004) SF-424 7 1.0000 7.00 0.7500 5.25 7 0.600 4.20
N/A (cleared under 4040-0006) SF-424A 7 1.0000 7.00 1.5000 10.50

0.00
N/A (Cleared under 4040-0007) SF-424B 7 1.0000 7.00 0.2500 1.75

0.00
N/A (Cleared under 0348-0046) SF-LLL 7 1.0000 7.00 0.2600 1.82

0.00

SUBTOTAL


2,024,007.00
1,012,068.25 500,007
200,004
















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.









National Animal Identification System -- Information requirements for participants 0579-0259







DATE PREPARED




November 1, 2008

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN









REPORTS RECORDS






















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER

(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
N/A State/Tribe/Territory Cooperative Agreement Application [0259] None 70 1.0000 70.00 20.0000 1,400.00 70 1.250 87.50
N/A 1890s, 1994 Tribal Land Grant, Hispanic Outreach/Education Cooperative Agreements [NEW] None 8 1.0000 8.00 20.0000 160.00 8 1.000 8.00
N/A Industry Cooperative Agreements Application - Premises Registration (business)[NEW] None 4 1.0000 4.00 20.0000 80.00 4 1.000 4.00
N/A State/Tribe Quarterly Accomplishment Reports (0259) None 70 4.0000 280.00 6.0000 1,680.00 70 10.000 700.00
N/A Industry Quarterly Accomplishment Reports [NEW] None 12 4.0000 48.00 0.2000 9.60 12 9.000 108.00





0.00
0.00








0.00
0.00




SUBTOTAL


410.00
3,329.60 164
907.50
















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.







TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

























National Animal Identification System -- Information requirements for participants 0579-0259































DATE PREPARED









1-Feb-08




















IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





ANNUAL BURDEN















REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF




(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS. (B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)

Industry cooperator quarterly accomplishment report

RESPONDENT



KEEPER

(A) SUBTOTAL (C) (D) (E) (F) (G) (H) (I) (J) (K)









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
























































TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.

















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.








0581-































DATE PREPARED






































ANNUAL BURDEN








IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT





REPORTS RECORDS









DESCRIPTION







TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-






(If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS

(B) so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)
SECTION OF


RESPONDENT



KEEPER

REGS.
(C) (D) (E) (F) (G) (H) (I) (J) (K)





0.00
0.00

0.00
(A)



0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


0.00
0.00

0.00









0.00
0.00

0.00









0.00
0.00 0
0.00
































File Typeapplication/vnd.ms-excel
Authoruser
Last Modified Bycbsickles
File Modified2008-11-25
File Created2000-01-10

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