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 | 0579-0369 | ||||||||||||||||||||||
DATE PREPARED | |||||||||||||||||||||||
May 6, 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 (AZ, AL, 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 (AZ, AL, CA, LA, TX, FL) (business) (10 of the respondents are the same respondents that label boxes) | None | 0.00 | 0.00 | 15 | 0.008 | 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, TX, AL, and FL (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 | Stratchko, Karen A (APHIS) |
File Modified | 2011-07-07 |
File Created | 2000-01-10 |