APHIS Form 79 Worksheet

---

Overview

APHIS Form 71
APHIS Form 79
Form Instructions

---

Sheet 1: APHIS Form 71

Identification of Reporting of Recordkeeping Requirement		Annual Burden
Section of Regulations	Description	Form No(s). (If "none" so state)	Reports					Records
			No. of Respon-dents	No. of Response per Respon-dent	Total Annual Responses	Hours per Response	Total Hours	No. of Record Keepers	Annual Hours per Record Keeper	Total Record-keeping Hours
					(Col. D x E)		(Col. F x G)			(Col. I x J)
(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)	(K)
					0		0
					0		0
					0		0
					0		0
[NOTE: Use File Page Setup Custom Header menu options to add title, OMB #, and date. Delete bold notes]					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
					0		0
			0		0		0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0
										0

---

Sheet 2: APHIS Form 79

Estimated Annual Program Costs for Collecting, Processing, Analyzing, Tabulating and/or Publishing the Information Collected (Do NOT include administrative costs such as printing and mailing of forms, etc.)								OMB Control No.
Reguations and Related Reporting and Recordkeeping Requirements Packers and Stockyards Programs, GIPSA								0580-0022.
Form No. or Other Identification		Total Annual Responses	Avg. Time Per Response	Total Hours Per Year	Persons Involved in the Information Collection*		Program Costs	Overhead Costs	Total Costs	Remarks
				(B x C)	Grade (GS)	Avg. Hourly Rate	(D x (E.2))	(F x 0.139)	(F + G)
(A)		(B)	(C)	(D)	(E.1)	(E.2)	(F)	(G)	(H)	(I)
	Estimated Annual Cost to the Federal Government	40	1.0	40	12/03	$38.27	$1,531	$213	$1,744
Totals									$1,744
*Include field and headquarters personnel. Use step 4 for average hourly rate.

---

Sheet 3: Form Instructions

Instructions for APHIS Form 71
	Use this form when a single information collection document involves multiple reporting and recordkeeping requirements.
	The totals of the figures in columns (D), (F), (H), (I), and (K) should be entered as items 17 and 18 of form OMB 83-I.
	For columns (E), (G), and (J), compute the averages of the totals as follows and then enter on the form OMB 83-I.
		Total	= (E) Average	(M) Total	= (G) Average	(K) Total	= (J) Average
		Total		(F) Total		(I) Total