Parts I & III Burden

Burden Computation - Business Forms
Page 1 of 1

August 13, 2013

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

1128/PARTS I & III

2009

Changes (+ -)

2009

2,000
______________
93
______________
1.00
______________
0.85
______________
53
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,000
______________
93
______________
1.00
______________
0.85
______________
53
______________

Computation of Changes
2,000 x _____________
35.31
Old Computation (Prog. Change) ______________
2,000
35.31
New Computation.............. ______________ x _____________
Balance...

=
=

70,620
_______________
70,620
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

70,620
_______________
0
_______________
_______________
70,620
_______________

Paperwork Reduction Act Notice
Time Per Response
35.31
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
22.24
______________
5.63
______________
7.18
______________
0.27
______________

Average Time
Per Response
22 hrs. , 14 min.
___________________
5 hrs. , 37 min.
___________________
7 hrs. , 10 min.
___________________
0 hrs. , 16 min.
___________________