2009 Burden

Burden Computation - Individual Forms
Page 1 of 1

August 17, 2009

Product:
Description:
Variables
Responses.......
Line Items......
Pages...........
Words...........
Code References.
Income Records..
Other Records...
Avg Lines used..

5213/
Election to Postpone Determination as To Whether the Presumption
2006

Changes (+ -)

2009

3,541
______________
7
______________
1.00
______________
1,525.00
______________
3
______________
0.00
______________
1.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

3,541
______________
7
______________
1.00
______________
1,525.00
______________
3
______________
0.00
______________
1.00
______________
0.00
______________

Computation of Changes
3,541 x _____________
0.78
Old Computation (Prog. Change) ______________
3,541
0.78
New Computation.............. ______________ x _____________
Balance...

=
=

2,762
_______________
2,762
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,762
_______________
0
_______________
_______________
2,762
_______________

Paperwork Reduction Act Notice
Time Per Response
0.78
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
0.11
______________
0.17
______________
0.16
______________
0.34
______________

0 hrs. , 06 min.
___________________
0 hrs. , 10 min.
___________________
0 hrs. , 09 min.
___________________
0 hrs. , 20 min.
___________________