2011 Burden Form SS-4

Burden Computation - Business Forms
Page 1 of 1

September 20, 2011

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

SS-4/
Application for Employer Identification Number
2008

Changes (+ -)

2011

1,546,042
______________
36
______________
0.00
______________
0.85
______________
7
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,546,042
______________
36
______________
0.00
______________
0.85
______________
7
______________

Computation of Changes
1,546,042 x _____________
10.17
Old Computation (Prog. Change) ______________
1,546,042
10.17
New Computation.............. ______________ x _____________
Balance...

=
=

15,723,248
_______________
15,723,248
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

15,723,248
_______________
0
_______________
_______________
15,723,248
_______________

Paperwork Reduction Act Notice
Time Per Response
10.17
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
8.61
______________
0.70
______________
0.87
______________
0.00
______________

Average Time
Per Response
8 hrs. , 36 min.
___________________
0 hrs. , 42 min.
___________________
0 hrs. , 52 min.
___________________
0 hrs. , 00 min.
___________________