Form 6069 Burden Computation

Burden Computation - Business Forms
Page 1 of 1

November 10, 2014

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

6069/
Return of Excise Tax on Excess Contributions to Black Lung Benefit Trust
2011

Changes (+ -)

2014

1
______________
30
______________
0.00
______________
0.85
______________
13
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1
______________
30
______________
0.00
______________
0.85
______________
13
______________

Computation of Changes
1 x _____________
9.93
Old Computation (Prog. Change) ______________
1 x _____________
9.93
New Computation.............. ______________
Balance...

=
=

10
_______________
10
_______________
_______________
0

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

1 x _____________
9.93
______________
1 x _____________
9.93
______________

=
=

10
_______________
10
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

10
_______________
0
_______________
0
_______________
10
_______________

Paperwork Reduction Act Notice
Time Per Response
9.93
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
7.17
______________
1.29
______________
1.46
______________
0.00
______________

Average Time
Per Response
7 hrs. , 10 min.
___________________
1 hrs. , 17 min.
___________________
1 hrs. , 27 min.
___________________
0 hrs. , 00 min.
___________________