Burden

Burden Computation - Business Forms
Page 1 of 1

June 18, 2013

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

972/
Consent of Shareholder to Include Specific Amount in Gross Income
2010

Changes (+ -)

2013

100
______________
15
______________
0.00
______________
0.85
______________
1
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

100
______________
15
______________
0.00
______________
0.85
______________
1
______________

Computation of Changes
100 x _____________
3.85
Old Computation (Prog. Change) ______________
100
3.85
New Computation.............. ______________ x _____________
Balance...

=
=

385
_______________
385
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

385
_______________
0
_______________
_______________
385
_______________

Paperwork Reduction Act Notice
Time Per Response
3.85
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
3.59
______________
0.10
______________
0.16
______________
0.00
______________

Average Time
Per Response
3 hrs. , 35 min.
___________________
0 hrs. , 06 min.
___________________
0 hrs. , 09 min.
___________________
0 hrs. , 00 min.
___________________