| 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. | ||||||||||||
| Imported Seed and Screenings (Foreign) | 0579-0124 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| July 23, 2009 | ||||||||||||||
| 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) | ||||
| 361.3(a), 361.4(b)(1) | Declarations for Importation (completed by brokers) (BUSINESS) | None | 550 | 20.00 | 11,000.00 | 0.17 | 1,826.00 | 0.00 | ||||||
| 351.3(b), 361.4(b)(3) | Labeling of Containers (completed by shippers) (BUSINESS) | None | 550 | 20.00 | 11,000.00 | 0.50 | 5,500.00 | 0.00 | ||||||
| 361.4(a)(5) | Documentation (BUSINESS) | None | 2 | 1.00 | 2.00 | 0.17 | 1.00 | 0.00 | ||||||
| 361.5(a) | Request for Return of Seeds (FOREIGN GOVERNMENT) | None | 5 | 1.00 | 5.00 | 0.08 | 1.00 | 0.00 | ||||||
| 361.5(d)(4) | Notify APHIS of Location of Seed (BUSINESS) | None | 3 | 1.00 | 3.00 | 0.17 | 1.00 | 0.00 | ||||||
| 361.7 | Seed Analysis Certificate of Canadian-grown seed - (FOREIGN GOVERNMENT) | PPQ 925 | 1 | 110.00 | 110.00 | 0.50 | 55.00 | 0.00 | ||||||
| 361.7 | Seed Analysis Certificate of Canadian-grown seed (BUSINESS) | PPQ 925 | 37 | 110.00 | 4,070.00 | 0.50 | 2,035.00 | 0.00 | ||||||
| SUBTOTAL | 1,148 | 26,190.00 | 9,419.00 | 0.00 | 0.00 | |||||||||
| TOTAL OF ALL PAGES | 1,168 | 26,480.00 | 9,579.00 | 500.00 | 9.00 | |||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 26,980.00 | 9,588.00 | ||||||||||||
| 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. | ||||||||||||
| Imported Seed and Screenings (Foreign) | 0579-0124 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| July 23, 2009 | ||||||||||||||
| 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) | ||||
| 361.8© | Compliance Agreement - (BUSINESS) | PPQ 519 | 10 | 2.00 | 20.00 | 1.25 | 25.00 | 0.00 | ||||||
| 361.8© | Written appeal for cancellations for compliance agreement and request a hearing (No burden determined as no appeals are anticipated)) | None | 0.00 | |||||||||||
| 361.8(a)(1) | Identity of seed maintained (BUSINESS) | None | 10 | 27.00 | 270.00 | 0.50 | 135.00 | 0.00 | ||||||
| 361.9(a) | Recordkeeping (BUSINESS) | 0.00 | 0.00 | 500 | 0.017 | 9.00 | ||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 20 | 290.00 | 160.00 | 500 | 9.00 | |||||||||
| 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 | ||||||||||
| 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 | ||||||||||
| 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 | ||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |