Burden computation for Form 8850

Burden Computation - Business Forms
Page 1 of 1

March 27, 2009

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

8850/
Pre-Screening Notice and Certification Request for the Work Opportunity
2009

Changes (+ -)

2009

400,000
______________
27
______________
0.00
______________
0.00
______________
5
______________

+40,000
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

440,000
______________
27
______________
0.00
______________
0.00
______________
5
______________

Computation of Changes
440,000 x _____________
4.73
Old Computation (Prog. Change) ______________
440,000
4.73
New Computation.............. ______________ x _____________
Balance...

=
=

2,081,200
_______________
2,081,200
_______________
_______________
0

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

400,000 x _____________
4.73
______________
______________
440,000 x _____________
4.73

=
=

1,892,000
_______________
_______________
2,081,200
_______________
+189,200

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,892,000
_______________
0
_______________
+189,200
_______________
2,081,200
_______________

Paperwork Reduction Act Notice
Time Per Response
4.73
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
3.27
______________
0.77
______________
0.70
______________
0.00
______________

Average Time
Per Response
3 hrs. , 16 min.
___________________
0 hrs. , 46 min.
___________________
0 hrs. , 42 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
Added 40,000 estimated responses as a result of PL 111-5.

Burden Computation - Business Forms
Page 1 of 1

March 27, 2009

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

8850/
Pre-Screening Notice and Certification Request for the Work Opportunity
2008

Changes (+ -)

2009

400,000
______________
23
______________
0.00
______________
0.00
______________
4
______________

_____________________________
+4
_____________________________
_____________________________
_____________________________
+1
_____________________________

400,000
______________
27
______________
0.00
______________
0.00
______________
5
______________

Computation of Changes
400,000 x _____________
3.99
Old Computation (Prog. Change) ______________
400,000
4.73
New Computation.............. ______________ x _____________
Balance...

=
=

1,596,000
_______________
1,892,000
_______________
_______________
+296,000

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,596,000
_______________
+296,000
_______________
_______________
1,892,000
_______________

Paperwork Reduction Act Notice
Time Per Response
4.73
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
3.27
______________
0.77
______________
0.70
______________
0.00
______________

Notes:
Added 4 lines and 1 Code reference.

Average Time
Per Response
3 hrs. , 16 min.
___________________
0 hrs. , 46 min.
___________________
0 hrs. , 42 min.
___________________
0 hrs. , 00 min.
___________________