| 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. | ||||||||||||
| Tomatoes w/Stems from the Republic of Korea into the US | 0579-0371 | |||||||||||||
| DATE PREPARED | ||||||||||||||
| August 14, 2013 | ||||||||||||||
| 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) | ||||
| 319.56-52 | Phytosanitary Certificate w/Declaration (Foreign Officials) | None | 1 | 1.0000 | 1.00 | 0.2500 | 1.00 | 0.00 | ||||||
| 319.56-52 | Monthly inspection of pest-exclusionary structures (Foreign Officials) | None | 1 | 1.0000 | 1.00 | 4.0000 | 4.00 | 0.00 | ||||||
| 319.56-51(b)(3) | Records of Trap Placement (Foreign Officials) (same respondents as inspection officials) | None | 1 | 0.001 | 1.00 | |||||||||
| 319.56.52 (a) | Registered pest-exclusionary structures (business) | None | 2 | 1.0000 | 2.00 | 0.5000 | 1.00 | 0.00 | ||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||
| SUBTOTAL | 3 | 4.00 | 6.00 | 1.00 | 1.00 | |||||||||
| TOTAL OF ALL PAGES | 4.00 | 6.00 | 1.00 | 1.00 | ||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 3 | 5.00 | 7.00 | |||||||||||
| 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. | ||||||||||||
| 0579- | ||||||||||||||
| 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 | ||||||||||
| 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/CDFV2-corrupt |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |