Combined Burden estimates

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/Parts I, II, and IV

2011

Changes (+ -)

2011

15,075
______________
79
______________
1.00
______________
0.85
______________
94
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

15,075
______________
79
______________
1.00
______________
0.85
______________
94
______________

Computation of Changes
15,075 x _____________
40.23
Old Computation (Prog. Change) ______________
15,075
40.23
New Computation.............. ______________ x _____________
Balance...

=
=

606,468
_______________
606,468
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

606,468
_______________
0
_______________
_______________
606,468
_______________

Paperwork Reduction Act Notice
Time Per Response
40.23
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
18.89
______________
9.70
______________
11.37
______________
0.27
______________

Average Time
Per Response
18 hrs. , 53 min.
___________________
9 hrs. , 42 min.
___________________
11 hrs. , 22 min.
___________________
0 hrs. , 16 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/Parts II, III, and IV

2008

Changes (+ -)

2011

1,668
______________
82
______________
1.00
______________
0.85
______________
99
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,668
______________
82
______________
1.00
______________
0.85
______________
99
______________

Computation of Changes
1,668 x _____________
41.98
Old Computation (Prog. Change) ______________
1,668
41.98
New Computation.............. ______________ x _____________
Balance...

=
=

70,023
_______________
70,023
_______________
_______________
0

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

1,668 x _____________
41.98
______________
______________
1,668 x _____________
41.98

=
=

70,023
_______________
_______________
70,023
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

70,023
_______________
0
_______________
0
_______________
70,023
_______________

Paperwork Reduction Act Notice
Time Per Response
41.98
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
19.61
______________
10.20
______________
11.90
______________
0.27
______________

Average Time
Per Response
19 hrs. , 36 min.
___________________
10 hrs. , 12 min.
___________________
11 hrs. , 54 min.
___________________
0 hrs. , 16 min.
___________________

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/SCH A

2008

Changes (+ -)

2011

5,336
______________
14
______________
1.00
______________
0.85
______________
15
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

5,336
______________
14
______________
1.00
______________
0.85
______________
15
______________

Computation of Changes
5,336 x _____________
8.40
Old Computation (Prog. Change) ______________
5,336
8.40
New Computation.............. ______________ x _____________
Balance...

=
=

44,823
_______________
44,823
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

44,823
_______________
0
_______________
_______________
44,823
_______________

Paperwork Reduction Act Notice
Time Per Response
8.40
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
3.35
______________
1.85
______________
2.93
______________
0.27
______________

Average Time
Per Response
3 hrs. , 21 min.
___________________
1 hrs. , 51 min.
___________________
2 hrs. , 55 min.
___________________
0 hrs. , 16 min.
___________________

Notes:
There is no change in the burden. When reporting to OMB DO NOT include the
number of responses in the total count. These responses are the same responses
reported under the "PartsI, II, and IV" or "Parts II, III, and IV".

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/SCH B

2008

Changes (+ -)

2011

1,334
______________
6
______________
0.00
______________
0.85
______________
5
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,334
______________
6
______________
0.00
______________
0.85
______________
5
______________

Computation of Changes
1,334 x _____________
2.47
Old Computation (Prog. Change) ______________
1,334
2.47
New Computation.............. ______________ x _____________
Balance...

=
=

3,295
_______________
3,295
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

3,295
_______________
0
_______________
_______________
3,295
_______________

Paperwork Reduction Act Notice
Time Per Response
2.47
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
1.43
______________
0.50
______________
0.55
______________
0.00
______________

Average Time
Per Response
1 hrs. , 25 min.
___________________
0 hrs. , 30 min.
___________________
0 hrs. , 33 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
DO NOT include the number of responses in the total count reported to OMB. These
responses are the same responses reported under the "Parts I, II, and IV" or "Parts
II, III, and IV".

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/SCH C

2008

Changes (+ -)

2011

1,000
______________
21
______________
1.00
______________
0.85
______________
4
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,000
______________
21
______________
1.00
______________
0.85
______________
4
______________

Computation of Changes
1,000 x _____________
7.87
Old Computation (Prog. Change) ______________
1,000
7.87
New Computation.............. ______________ x _____________
Balance...

=
=

7,870
_______________
7,870
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

7,870
_______________
0
_______________
_______________
7,870
_______________

Paperwork Reduction Act Notice
Time Per Response
7.87
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
5.02
______________
0.76
______________
1.81
______________
0.27
______________

Average Time
Per Response
5 hrs. , 01 min.
___________________
0 hrs. , 45 min.
___________________
1 hrs. , 48 min.
___________________
0 hrs. , 16 min.
___________________

Notes:
DO Not include the number of responses in the total count reported to OMB.
resposes are included under "Parts I, II, and IV" or "Parts II, III, and IV".

These

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/SCH D

2008

Changes (+ -)

2011

2,000
______________
115
______________
0.00
______________
0.85
______________
20
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,000
______________
115
______________
0.00
______________
0.85
______________
20
______________

Computation of Changes
2,000 x _____________
32.01
Old Computation (Prog. Change) ______________
2,000
32.01
New Computation.............. ______________ x _____________
Balance...

=
=

64,020
_______________
64,020
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

64,020
_______________
0
_______________
_______________
64,020
_______________

Paperwork Reduction Act Notice
Time Per Response
32.01
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
27.50
______________
1.99
______________
2.52
______________
0.00
______________

Average Time
Per Response
27 hrs. , 30 min.
___________________
1 hrs. , 59 min.
___________________
2 hrs. , 31 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
DO NOT include the number of responses in the total count to OMB. These
responses are already accounted for in "Parts I, II, and IV" or "Parts II, III, and
IV".

Burden Computation - Business Forms
Page 1 of 1

May 11, 2011

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

3115/SCH E

2011

Changes (+ -)

2011

16,675
______________
16
______________
0.00
______________
0.85
______________
20
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

16,675
______________
16
______________
0.00
______________
0.85
______________
20
______________

Computation of Changes
16,675 x _____________
7.95
Old Computation (Prog. Change) ______________
16,675
7.95
New Computation.............. ______________ x _____________
Balance...

=
=

132,567
_______________
132,567
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

132,567
_______________
0
_______________
_______________
132,567
_______________

Paperwork Reduction Act Notice
Time Per Response
7.95
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Average Hours
Per Response
3.83
______________
1.99
______________
2.14
______________
0.00
______________

Average Time
Per Response
3 hrs. , 49 min.
___________________
1 hrs. , 59 min.
___________________
2 hrs. , 08 min.
___________________
0 hrs. , 00 min.
___________________

Notes:
DO NOT include the number of responses in the total count to OMB. These
responses are already accounted for in "Parts I, II, and IV" or "Parts II, III, and
IV".