| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| Citus Canker, Citrus Greening, and Asian Citrus Psyllid; Interstate Movement of Regulated Nursery Stock - APHIS 2010-0048 | 0579- | ||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| February 9, 2011 | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 301.75-6, 76-6, 76-7 | Labeling requirements (CA, LA, TX, and FL) (business) | None | 27 | 274.0000 | 7,398.00 | 0.0200 | 147.96 | 0.00 | |||||||||||||||
| 301.75-6, 76-7, 76-7 | Recordkeeping of Nursery (CA, LA, TX, FL) (business) (10 of the respondents are the same respondents that label boxes) | None | 0.00 | 0.00 | 15 | 0.083 | 1.00 | ||||||||||||||||
| 301.75-6, 76-6, 7, 8 | Compliance Agreements (business | PPQ 519 | 569 | 1.0000 | 569.00 | 1.2500 | 711.25 | 0.00 | |||||||||||||||
| 301.76-6 ( c) | Limited Permit, LA, AZ, CA (business) | PPQ 530 | 25 | 104.0000 | 2,600.00 | 0.2000 | 520.00 | 0.00 | |||||||||||||||
| 301-75-6, 76-7 | Federal Certificate (business) (same respondents as PPQ 530 | PPQ 540 | 25 | 104.0000 | 2,600.00 | 0.2000 | 520.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 621 | 13,167.00 | 1,899.21 | 15.00 | 1.00 | ||||||||||||||||||
| TOTAL OF ALL PAGES | 13,167.00 | 1,899.21 | 15.00 | 1.00 | |||||||||||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 13,182.00 | 1,900.21 | |||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0579- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||||||||||||
| 0581- | |||||||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||||||||
| TOTAL | |||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||||||||
| RESPONDENT | KEEPER | ||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||||||||
| File Type | application/vnd.ms-excel |
| Author | user |
| Last Modified By | kastratchko |
| File Modified | 2011-02-17 |
| File Created | 2000-01-10 |