2012 Burden Form 8876-A

Burden Computation - Business Forms
Page 1 of 1

March 8, 2012

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

4876A/
Election to Be Treated as an Interest Charge DISC
2009

Changes (+ -)

2012

1,000
______________
17
______________
0.00
______________
0.85
______________
11
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,000
______________
17
______________
0.00
______________
0.85
______________
11
______________

Computation of Changes
1,000 x _____________
6.36
Old Computation (Prog. Change) ______________
1,000
6.36
New Computation.............. ______________ x _____________
Balance...

=
=

6,360
_______________
6,360
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

6,360
_______________
0
_______________
_______________
6,360
_______________

Paperwork Reduction Act Notice
Time Per Response
6.36
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
4.07
______________
1.09
______________
1.21
______________
0.00
______________

Average Time
Per Response
4 hrs. , 04 min.
___________________
1 hrs. , 05 min.
___________________
1 hrs. , 12 min.
___________________
0 hrs. , 00 min.
___________________