09 burden

Burden Computation - Individual Forms
Page 1 of 1

October 23, 2009

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

1045/
Application for Tentative Refund
2009

Changes (+ -)

2009

17,503
______________
319
______________
4.00
______________
9,402.00
______________
12
______________
0.00
______________
18.00
______________
0.85
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

17,503
______________
319
______________
4.00
______________
9,402.00
______________
12
______________
0.00
______________
18.00
______________
0.85
______________

Computation of Changes
17,503 x _____________
29.43
Old Computation (Prog. Change) ______________
17,503 x _____________
29.43
New Computation.............. ______________
Balance...

=
=

515,114
_______________
515,114
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

515,114
_______________
0
_______________
_______________
515,114
_______________

Paperwork Reduction Act Notice
Time Per Response
29.43
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:
No change.

Average Hours
Per Response
9.31
______________
9.12
______________
9.95
______________
1.05
______________

9 hrs. , 18 min.
___________________
9 hrs. , 07 min.
___________________
9 hrs. , 57 min.
___________________
1 hrs. , 03 min.
___________________