2009 burden estimates

Burden Computation - Business Forms
Page 1 of 1

November 14, 2009

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

1041/Un Section 1250 WK-L 15d

2007

Changes (+ -)

2009

200,000
______________
18
______________
0.00
______________
0.85
______________
2
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

200,000
______________
18
______________
0.00
______________
0.85
______________
2
______________

Computation of Changes
200,000 x _____________
4.78
Old Computation (Prog. Change) ______________
200,000
4.78
New Computation.............. ______________ x _____________
Balance...

=
=

956,000
_______________
956,000
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

956,000
_______________
0
_______________
_______________
956,000
_______________

Paperwork Reduction Act Notice
Time Per Response
4.78
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
4.30
______________
0.20
______________
0.28
______________
0.00
______________

Average Time
Per Response
4 hrs. , 18 min.
___________________
0 hrs. , 12 min.
___________________
0 hrs. , 16 min.
___________________
0 hrs. , 00 min.
___________________