2015 Burden-Form 4136 Line 2

Burden Computation - Business Forms
Page 1 of 1

July 21, 2015

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

4136/Line 2

2015

Changes (+ -)

2015

2,686
______________
7
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,686
______________
7
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
2,686 x _____________
1.70
Old Computation (Prog. Change) ______________
2,686
1.70
New Computation.............. ______________ x _____________
Balance...

=
=

4,567
_______________
4,567
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

4,567
_______________
0
_______________
_______________
4,567
_______________

Paperwork Reduction Act Notice
Time Per Response
1.70
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
1.67
______________
0.00
______________
0.03
______________
0.00
______________

Average Time
Per Response
1 hrs. , 40 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 01 min.
___________________
0 hrs. , 00 min.
___________________