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pdfBurden Computation - Special Business Forms
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February 6, 2015
Product:
Description:
8966-C/
Cover Sheet for Form 8966 Paper Submissions
Variables
Responses.......
Line Items......
Forms Prepared..
______________
______________
______________
Changes (+ -)
2015
+1,000
_____________________________
+8
_____________________________
+0.85
_____________________________
1,000
______________
8
______________
0.85
______________
Computation of Changes
1,000 x _____________
Old Computation (Prog. Change) ______________
1,000 x _____________
0.12
New Computation.............. ______________
Balance...
=
=
_______________
120
_______________
+120
_______________
Old Computation (Adjustment)
New Computation..............
Balance...
______________ x _____________
______________ x _____________
=
=
_______________
_______________
_______________
Old Computation..............
New Computation..............
Balance...
______________ x _____________
______________ x _____________
=
=
_______________
_______________
_______________
Summary
Old Burden...................................................
Program Change...............................................
Adjustment...................................................
New Burden...................................................
_______________
+120
_______________
_______________
120
_______________
Paperwork Reduction Act Notice
Time Per Response
0.12
Record Keeping............
Learning..................
Preparing.................
Sending...................
Notes:
Average Hours
Per Response
______________
______________
______________
0.12
______________
Average Time
Per Response
___________________
___________________
___________________
0 hrs. , 07 min.
___________________
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