Burden

Burden Computation - Individual Forms
Page 1 of 1

October 7, 2013

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

2210 LONG (1,2,4,A1)/2210 LONG (1,2,4,A1)

2013

Changes (+ -)

2013

366,666
______________
178
______________
2.50
______________
6,058.00
______________
4
______________
0.00
______________
2.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

366,666
______________
178
______________
2.50
______________
6,058.00
______________
4
______________
0.00
______________
2.00
______________
0.00
______________

Computation of Changes
366,666 x _____________
5.65
Old Computation (Prog. Change) ______________
366,666 x _____________
5.65
New Computation.............. ______________
Balance...

=
=

2,071,663
_______________
2,071,663
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,071,663
_______________
0
_______________
_______________
2,071,663
_______________

Paperwork Reduction Act Notice
Time Per Response
5.65
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.22
______________
0.57
______________
4.17
______________
0.69
______________

0 hrs. , 13 min.
___________________
0 hrs. , 34 min.
___________________
4 hrs. , 10 min.
___________________
0 hrs. , 41 min.
___________________