2011 Burden Form 1028

Burden Computation - Business Forms
Page 1 of 1

March 24, 2011

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

1028/
Application for Recognition of Exemption Under Section 521 of the Internal
2008

Changes (+ -)

2011

50
______________
185
______________
2.00
______________
0.85
______________
10
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

50
______________
185
______________
2.00
______________
0.85
______________
10
______________

Computation of Changes
50 x _____________
50.90
Old Computation (Prog. Change) ______________
50
50.90
New Computation.............. ______________ x _____________
Balance...

=
=

2,545
_______________
2,545
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,545
_______________
0
_______________
_______________
2,545
_______________

Paperwork Reduction Act Notice
Time Per Response
50.90
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
44.24
______________
1.73
______________
4.39
______________
0.54
______________

Average Time
Per Response
44 hrs. , 14 min.
___________________
1 hrs. , 43 min.
___________________
4 hrs. , 23 min.
___________________
0 hrs. , 32 min.
___________________