Burden

Burden Computation - Individual Forms
Page 1 of 1

September 15, 2010

Product:
Description:

8938/
Statement of Foreign Financial Assets

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

______________
______________
______________
______________
______________
______________
______________
______________

Changes (+ -)

2010

+350,000
_____________________________
+20
_____________________________
+2.00
_____________________________
+341.00
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

350,000
______________
20
______________
2.00
______________
341.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

Computation of Changes
350,000 x _____________
Old Computation (Prog. Change) ______________
350,000 x _____________
1.08
New Computation.............. ______________
Balance...

=
=

_______________
378,000
_______________
_______________
+378,000

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+378,000
_______________
_______________
378,000
_______________

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

Notes:
New form.

Average Hours
Per Response
0.00
______________
0.03
______________
0.47
______________
0.58
______________

0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 28 min.
___________________
0 hrs. , 34 min.
___________________