Form 8938 Burden recaculation

Burden Computation - Individual Forms
Page 1 of 1

June 20, 2013

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

8938/
Statement of Foreign Financial Assets
2010

Changes (+ -)

2013

350,000
______________
20
______________
2.00
______________
341.00
______________
0
______________
0.00
______________
0.00
______________
0.00
______________

_____________________________
+103
_____________________________
+1.00
_____________________________
+9,590.00
_____________________________
+9
_____________________________
_____________________________
_____________________________
_____________________________

350,000
______________
123
______________
3.00
______________
9,931.00
______________
9
______________
0.00
______________
0.00
______________
0.00
______________

Computation of Changes
350,000 x _____________
1.08
Old Computation (Prog. Change) ______________
350,000 x _____________
4.65
New Computation.............. ______________
Balance...

=
=

378,000
_______________
1,627,500
_______________
_______________
+1,249,500

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

378,000
_______________
+1,249,500
_______________
_______________
1,627,500
_______________

Paperwork Reduction Act Notice
Time Per Response
4.65
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.00
______________
0.96
______________
2.88
______________
0.81
______________

0 hrs. , 00 min.
___________________
0 hrs. , 57 min.
___________________
2 hrs. , 52 min.
___________________
0 hrs. , 48 min.
___________________