Burden

Burden Computation - Business Forms
Page 1 of 1

October 14, 2009

Product:
Description:

11-C/11-C (V) Preprinted

Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

______________
______________
______________
______________
______________

Changes (+ -)

2009

+500
_____________________________
+6
_____________________________
_____________________________
+0.13
_____________________________
_____________________________

500
______________
6
______________
0.00
______________
0.13
______________
0
______________

Computation of Changes
500 x _____________
Old Computation (Prog. Change) ______________
500 x _____________
0.97
New Computation.............. ______________
Balance...

=
=

_______________
485
_______________
_______________
+485

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

______________ x _____________
______________
500 x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+485
_______________
_______________
485
_______________

Paperwork Reduction Act Notice
Time Per Response
0.97
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.83
______________
0.00
______________
0.14
______________
0.00
______________

Average Time
Per Response
0 hrs. , 49 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 08 min.
___________________
0 hrs. , 00 min.
___________________