Box 5 burden

Burden Computation - Special Business Forms
Page 1 of 1

August 13, 2009

Product:
Description:
Variables
Responses.......
Line Items......
Forms Prepared..

1099INT/Box 5

2007

Changes (+ -)

2009

1,000,000
______________
1
______________
0.85
______________

_____________________________
_____________________________
_____________________________

1,000,000
______________
1
______________
0.85
______________

Computation of Changes
1,000,000 x _____________
0.02
Old Computation (Prog. Change) ______________
1,000,000 x _____________
0.02
New Computation.............. ______________
Balance...

=
=

20,000
_______________
20,000
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

20,000
_______________
0
_______________
_______________
20,000
_______________

Paperwork Reduction Act Notice
Time Per Response
0.02
Record Keeping............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
______________
______________
______________
0.02
______________

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