Burden

Burden Computation - Business Forms
Page 1 of 1

June 26, 2012

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

5310/
Application for Determination for Terminating Plan
2009

Changes (+ -)

2012

15,000
______________
269
______________
2.00
______________
0.85
______________
210
______________

_____________________________
-30
_____________________________
_____________________________
_____________________________
-19
_____________________________

15,000
______________
239
______________
2.00
______________
0.85
______________
191
______________

Computation of Changes
15,000 x _____________
111.91
Old Computation (Prog. Change) ______________
15,000
100.77
New Computation.............. ______________ x _____________
Balance...

=
=

1,678,650
_______________
1,511,550
_______________
_______________
-167,100

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

15,000 x _____________
111.91
______________
______________
15,000 x _____________
111.91

=
=

1,678,650
_______________
_______________
1,678,650
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,678,650
_______________
-167,100
_______________
0
_______________
1,511,550
_______________

Paperwork Reduction Act Notice
Time Per Response
100.77
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
57.16
______________
19.70
______________
23.37
______________
0.54
______________

Average Time
Per Response
57 hrs. , 09 min.
___________________
19 hrs. , 42 min.
___________________
23 hrs. , 22 min.
___________________
0 hrs. , 32 min.
___________________