Burden Computation - Individual Forms
July 22, 2010
Page 1 of 1
Responses....... ______________ _____________________________ ______________
Line Items...... ______________ _____________________________ ______________
Pages........... ______________ _____________________________ ______________
Words........... ______________ _____________________________ ______________
Code References. ______________ _____________________________ ______________
Income Records.. ______________ _____________________________ ______________
Other Records... ______________ _____________________________ ______________
Avg Lines used.. ______________ _____________________________ ______________
2.00
10,000
0.00
0
0.00
0.00
0.85
18
10,000
18
2.00
0.00
0
0.00
0.00
0.85
Computation of Changes
Summary
Old Burden................................................... _______________
Program Change............................................... _______________
Adjustment................................................... _______________
New Burden................................................... _______________
Old Computation (Prog. Change) ______________ x _____________ = _______________
New Computation.............. ______________ x _____________ = _______________
Balance... _______________
Old Computation (Adjustment) ______________ x _____________ = _______________
New Computation.............. ______________ x _____________ = _______________
Balance... _______________
Old Computation.............. ______________ x _____________ = _______________
New Computation.............. ______________ x _____________ = _______________
Balance... _______________
0
14,700
14,700
Paperwork Reduction Act Notice
Time Per Response
Average Hours
Per Response
Notes:
Recordkeeping............. ______________ ___________________
Learning.................. ______________ ___________________
Preparing................. ______________ ___________________
Sending................... ______________ ___________________
0.00
0.44
0.45
0.58
0 hrs. , 00 min.
0 hrs. , 26 min.
0 hrs. , 27 min.
0 hrs. , 34 min.
1.47
No change.
Variables
Changes (+ -)
2009
2009
Product:
Description:
1041 (SCH D-1)/Continuation Sheet of Sch. D
10,000
1.47
14,700
10,000
1.47
14,700
0
| File Type | application/pdf |
| File Title | 2009 SchD-1 Cont |
| Author | Oracle Reports |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |