Burden

Burden Computation - Individual Forms
Page 1 of 1

January 25, 2012

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

1127-A/
Application for Extension of Time for Payment of Income Tax Due to
2011

Changes (+ -)

2012

1,000
______________
17
______________
2.00
______________
2,318.00
______________
5
______________
1.00
______________
1.00
______________
______________

_____________________________
-6
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

1,000
______________
11
______________
2.00
______________
2,318.00
______________
5
______________
1.00
______________
1.00
______________
______________

Computation of Changes
1,000 x _____________
1.35
Old Computation (Prog. Change) ______________
1,000 x _____________
1.21
New Computation.............. ______________
Balance...

=
=

1,350
_______________
1,210
_______________
_______________
-140

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

1.35
______________
1,000 x _____________
1,000 x _____________
1.35
______________

=
=

1,350
_______________
1,350
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

1,350
_______________
-140
_______________
0
_______________
1,210
_______________

Paperwork Reduction Act Notice
Time Per Response
1.21
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
0.11
______________
0.26
______________
0.26
______________
0.58
______________

0 hrs. , 06 min.
___________________
0 hrs. , 15 min.
___________________
0 hrs. , 15 min.
___________________
0 hrs. , 34 min.
___________________