Burden for Form 1139

Burden Computation - Business Forms
Page 1 of 1

March 17, 2009

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

1139/
Corporation Application for Tentative Refund
2006

Changes (+ -)

2009

3,000
______________
116
______________
5.00
______________
0.85
______________
31
______________

+750
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

3,750
______________
116
______________
5.00
______________
0.85
______________
31
______________

Computation of Changes
3,750 x _____________
44.25
Old Computation (Prog. Change) ______________
3,750
44.25
New Computation.............. ______________ x _____________
Balance...

=
=

165,938
_______________
165,938
_______________
_______________
0

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

3,000 x _____________
44.25
______________
______________
3,750 x _____________
44.25

=
=

132,750
_______________
_______________
165,938
_______________
+33,188

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

132,750
_______________
0
_______________
+33,188
_______________
165,938
_______________

Paperwork Reduction Act Notice
Time Per Response
44.25
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
27.74
______________
4.92
______________
10.24
______________
1.34
______________

Notes:
Added 750 estimated responses as a result of PL 111-5.

Average Time
Per Response
27 hrs. , 44 min.
___________________
4 hrs. , 55 min.
___________________
10 hrs. , 14 min.
___________________
1 hrs. , 20 min.
___________________