Burden

Burden Computation - Individual Forms
Page 1 of 1

September 27, 2012

Product:
Description:

4972/
Tax on Lump-Sum Distributions

Variables
Responses.......
Line Items......
Pages...........
Words...........
Code References.
Income Records..
Other Records...
Avg Lines used..

______________
______________
______________
______________
______________
______________
______________
______________

Changes (+ -)

2012

+13,922
_____________________________
+51
_____________________________
+1.00
_____________________________
+3,444.00
_____________________________
+3
_____________________________
+8.00
_____________________________
+8.00
_____________________________
+0.85
_____________________________

13,922
______________
51
______________
1.00
______________
3,444.00
______________
3
______________
8.00
______________
8.00
______________
0.85
______________

Computation of Changes
13,922 x _____________
Old Computation (Prog. Change) ______________
13,922 x _____________
4.40
New Computation.............. ______________
Balance...

=
=

_______________
61,257
_______________
_______________
+61,257

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

______________ x _____________
13,922 x _____________
______________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+61,257
_______________
_______________
61,257
_______________

Paperwork Reduction Act Notice
Time Per Response
4.40
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.32
______________
1.61
______________
2.13
______________
0.34
______________

0 hrs. , 19 min.
___________________
1 hrs. , 36 min.
___________________
2 hrs. , 07 min.
___________________
0 hrs. , 20 min.
___________________