2009 Burden

Burden Computation - Business Forms
Page 1 of 1

June 12, 2009

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

8905/
Certification of Intent to Adopt a Pre-approved Plan
2006

Changes (+ -)

29,000
______________
14
______________
0.00
______________
0.85
______________
2
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2009
29,000
______________
14
______________
0.00
______________
0.85
______________
2
______________

Computation of Changes
29,000 x _____________
3.81
Old Computation (Prog. Change) ______________
29,000 x _____________
3.81
New Computation.............. ______________
Balance...

=
=

110,490
_______________
110,490
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

110,490
_______________
0
_______________
_______________
110,490
_______________

Paperwork Reduction Act Notice
Time Per Response
3.81
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
3.35
______________
0.20
______________
0.26
______________
0.00
______________

Average Time
Per Response
3 hrs. , 21 min.
___________________
0 hrs. , 12 min.
___________________
0 hrs. , 15 min.
___________________
0 hrs. , 00 min.
___________________