2014 Burden Form 1028

Burden Computation - Business Forms
Page 1 of 1

November 10, 2014

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

1028/
Application for Recognition of Exemption Under Section 521 of the Internal
2011

Changes (+ -)

2014

50
______________
185
______________
2.00
______________
0.85
______________
10
______________

_____________________________
+3
_____________________________
+11.00
_____________________________
_____________________________
-6
_____________________________

50
______________
188
______________
13.00
______________
0.85
______________
4
______________

Computation of Changes
50 x _____________
50.90
Old Computation (Prog. Change) ______________
50 x _____________
71.88
New Computation.............. ______________
Balance...

=
=

2,545
_______________
3,594
_______________
_______________
+1,049

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

50 x _____________
50.90
______________
50 x _____________
50.90
______________

=
=

2,545
_______________
2,545
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,545
_______________
+1,049
_______________
0
_______________
3,594
_______________

Paperwork Reduction Act Notice
Time Per Response
71.88
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
44.96
______________
5.19
______________
18.24
______________
3.49
______________

Average Time
Per Response
44 hrs. , 57 min.
___________________
5 hrs. , 11 min.
___________________
18 hrs. , 14 min.
___________________
3 hrs. , 29 min.
___________________