|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Prohibited and Restricted Importation of Hams into the United States. |
0579-XXXX |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| July 30, 2012 |
| 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) |
|
|
|
|
10,386 |
|
|
|
RESPONDENT |
|
|
|
|
KEEPER |
|
| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
(K) |
| 94.17(d) |
Certification for Importantion of Hams (business) |
0 |
92 |
531.00 |
48,852.00 |
1.00 |
48,852 |
0 |
0.000 |
0 |
|
trbutler:
94.17(o) |
Certification for Importantion of Hams (Foreign Gov't) |
|
1 |
92.00 |
92.00 |
1.00 |
92 |
0 |
0.000 |
0 |
|
trbutler:
94.17(g) |
Agreement between processing establishment and VS for processing procedures for hams (Business) |
letter |
92 |
1.00 |
92.00 |
1.00 |
92 |
0 |
0.000 |
0 |
| 94.17(j)(2) |
Identification Procedures (hot brand or ink seal - Business) |
0 |
92 |
1.00 |
92.00 |
1.00 |
92 |
0 |
0.000 |
0 |
| 94.17(k) |
Record Keeping for Processing Origin (maintaining records) |
0 |
0 |
0.00 |
0.00 |
0.00 |
0 |
92 |
1.000 |
92 |
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
|
|
49,128.00 |
|
49,128 |
92.00 |
|
92 |
|
TOTAL OF ALL PAGES |
|
93 |
|
49,128.00 |
|
49,128 |
92.00 |
|
92 |
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c |
|
|
|
49,220.00 |
|
49,220.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Restricted and Controlled Importation of Nonfood Animal and Poultry Products and By Products into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| October 13, 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Restricted and Controlled Importation of Nonfood Animal and Poultry Products and By Products into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| October 13, 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Restricted and Controlled Importation of Nonfood Animal and Poultry Products and By Products into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| October 13, 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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) |
trbutler:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SUBTOTAL |
|
|
|
0.00 |
|
0.00 |
0 |
|
0.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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. |
|
|
|
|
|
|
|
|
| Importation of Restricted and Controlled Animal and Poultry Products and Byproducts, Organisms, and Vectors into the United States |
0579-0015 |
|
|
|
|
|
| DATE PREPARED |
|
|
|
| September 29, 2008 |
| 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 |
|
0.00 |
|
|
|
|
|
0.00 |
|
0.00 |
0 |
|
0.00 |
|
|
|
|
|
0.00 |
|
0.00 |
0 |
|
0.00 |
|
|
|
|
|
0.00 |
|
0.00 |
0 |
|
0.00 |
|
|
|
|
|
0.00 |
|
0.00 |
0 |
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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 |