2012 Burden Form 4461-A

Burden Computation - Business Forms
Page 1 of 1

January 23, 2012

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

4461A/
Application for Approval of Master or Prototype or Volume Submitter
2011

Changes (+ -)

2012

250
______________
176
______________
1.00
______________
0.85
______________
56
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

250
______________
176
______________
1.00
______________
0.85
______________
56
______________

Computation of Changes
250 x _____________
56.10
Old Computation (Prog. Change) ______________
250
56.10
New Computation.............. ______________ x _____________
Balance...

=
=

14,025
_______________
14,025
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

14,025
_______________
0
_______________
_______________
14,025
_______________

Paperwork Reduction Act Notice
Time Per Response
56.10
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
42.09
______________
5.93
______________
7.81
______________
0.27
______________

Average Time
Per Response
42 hrs. , 05 min.
___________________
5 hrs. , 55 min.
___________________
7 hrs. , 48 min.
___________________
0 hrs. , 16 min.
___________________