2010 burden estimate

Burden Computation - Business Forms
Page 1 of 1

April 27, 2010

Product:
Description:

W-11/
Hiring Incentives to Restore Employment (HIRE) Act Employee Affidavit

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

______________
______________
______________
______________
______________

Changes (+ -)

2010

+100,000
_____________________________
+6
_____________________________
_____________________________
+0.85
_____________________________
+4
_____________________________

100,000
______________
6
______________
0.00
______________
0.85
______________
4
______________

Computation of Changes
100,000 x _____________
Old Computation (Prog. Change) ______________
100,000 x _____________
2.27
New Computation.............. ______________
Balance...

=
=

_______________
227,000
_______________
_______________
+227,000

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

______________ x _____________
______________
100,000 x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+227,000
_______________
_______________
227,000
_______________

Paperwork Reduction Act Notice
Time Per Response
2.27
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
1.43
______________
0.40
______________
0.43
______________
0.00
______________

Average Time
Per Response
1 hrs. , 25 min.
___________________
0 hrs. , 24 min.
___________________
0 hrs. , 25 min.
___________________
0 hrs. , 00 min.
___________________