Burden Calculation

Burden Computation - Individual Forms
Page 1 of 1

April 6, 2015

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

4029/
Application for Exemption From Social Security and Medicare Taxes and
2012

Changes (+ -)

2015

3,754
______________
13
______________
0.75
______________
2,520.00
______________
9
______________
0.00
______________
1.00
______________
0.00
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

3,754
______________
13
______________
0.75
______________
2,520.00
______________
9
______________
0.00
______________
1.00
______________
______________

Computation of Changes
3,754 x _____________
1.01
Old Computation (Prog. Change) ______________
3,754 x _____________
1.01
New Computation.............. ______________
Balance...

=
=

3,792
_______________
3,792
_______________
_______________
0

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

1.01
______________
3,754 x _____________
3,754 x _____________
1.01
______________

=
=

3,792
_______________
3,792
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

3,792
_______________
0
_______________
0
_______________
3,792
_______________

Paperwork Reduction Act Notice
Time Per Response
1.01
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.11
______________
0.32
______________
0.30
______________
0.28
______________

0 hrs. , 06 min.
___________________
0 hrs. , 19 min.
___________________
0 hrs. , 18 min.
___________________
0 hrs. , 16 min.
___________________