2009 Burden Worksheet 3

Burden Computation - Individual Forms
Page 1 of 1

September 8, 2009

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

8582CR/WKST 3

2006

Changes (+ -)

2009

30,000
______________
7
______________
0.00
______________
89.00
______________
0
______________
0.00
______________
1.00
______________
0.85
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

30,000
______________
7
______________
0.00
______________
89.00
______________
0
______________
0.00
______________
1.00
______________
0.85
______________

Computation of Changes
30,000 x _____________
1.08
Old Computation (Prog. Change) ______________
30,000
1.08
New Computation.............. ______________ x _____________
Balance...

=
=

32,400
_______________
32,400
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

32,400
_______________
0
_______________
_______________
32,400
_______________

Paperwork Reduction Act Notice
Time Per Response
1.08
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.52
______________
0.17
______________
0.28
______________
0.11
______________

0 hrs. , 31 min.
___________________
0 hrs. , 10 min.
___________________
0 hrs. , 16 min.
___________________
0 hrs. , 06 min.
___________________