Burden for Form 8941

Burden Computation - Business Forms
Page 1 of 1

December 1, 2010

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

8941/
Credit for Small Employer Health Insurance Premiums
2010

Changes (+ -)

2010

3,046,964
______________
27
______________
0.00
______________
0.85
______________
14
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

3,046,964
______________
27
______________
0.00
______________
0.85
______________
14
______________

Computation of Changes
3,046,964 x _____________
9.40
Old Computation (Prog. Change) ______________
3,046,964
9.40
New Computation.............. ______________ x _____________
Balance...

=
=

28,641,462
_______________
28,641,462
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

28,641,462
_______________
0
_______________
_______________
28,641,462
_______________

Paperwork Reduction Act Notice
Time Per Response
9.40
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
6.46
______________
1.39
______________
1.55
______________
0.00
______________

Average Time
Per Response
6 hrs. , 27 min.
___________________
1 hrs. , 23 min.
___________________
1 hrs. , 33 min.
___________________
0 hrs. , 00 min.
___________________