burden

Burden Computation - Business Forms
Page 1 of 1

January 31, 2011

Product:
Description:

8940/
Request for Miscellaneous Determination

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

______________
______________
______________
______________
______________

Changes (+ -)

2011

+2,100
_____________________________
+20
_____________________________
_____________________________
+0.85
_____________________________
+44
_____________________________

2,100
______________
20
______________
0.00
______________
0.85
______________
44
______________

Computation of Changes
2,100 x _____________
Old Computation (Prog. Change) ______________
2,100 x _____________
13.79
New Computation.............. ______________
Balance...

=
=

_______________
28,959
_______________
_______________
+28,959

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

______________ x _____________
______________
2,100 x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+28,959
_______________
_______________
28,959
_______________

Paperwork Reduction Act Notice
Time Per Response
13.79
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
4.78
______________
4.37
______________
4.64
______________
0.00
______________

Average Time
Per Response
4 hrs. , 46 min.
___________________
4 hrs. , 22 min.
___________________
4 hrs. , 38 min.
___________________
0 hrs. , 00 min.
___________________