2011 Burden Form 8223

Burden Computation - Individual Forms
Page 1 of 1

September 2, 2014

Product:
Description:

8233/
Exemption From Withholding on Compensation for Independent (and

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

______________
______________
______________
______________
______________
______________
______________
______________

Changes (+ -)

2014

+75,617
_____________________________
+41
_____________________________
+1.50
_____________________________
+4,446.00
_____________________________
+19
_____________________________
+3.00
_____________________________
+10.00
_____________________________
+0.85
_____________________________

75,617
______________
41
______________
1.50
______________
4,446.00
______________
19
______________
3.00
______________
10.00
______________
0.85
______________

Computation of Changes
75,617 x _____________
Old Computation (Prog. Change) ______________
75,617 x _____________
9.05
New Computation.............. ______________
Balance...

=
=

_______________
684,334
_______________
+684,334
_______________

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

______________ x _____________
75,617 x _____________
______________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+684,334
_______________
_______________
684,334
_______________

Paperwork Reduction Act Notice
Time Per Response
9.05
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
3.74
______________
2.76
______________
2.09
______________
0.46
______________

3 hrs. , 44 min.
___________________
2 hrs. , 45 min.
___________________
2 hrs. , 05 min.
___________________
0 hrs. , 27 min.
___________________

Notes:
Number of responses obtained from newly implemented application: International
National Standard Application (NSA) Database registers incoming forms.