| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| Mandatory Country of Origin Labeling of Covered Commodities | 0581-0250 | |||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| May 16, 2016 | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| Storing & Maintenance for Establishments | 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| Livestock and Farm-Raised Fish and Shellfish Producers | 0.00 | 0.00 | 222,327 | 12.000 | 2,667,924.00 | |||||||||||||||||||
| Chicken, Wild Fish and Shellfish, Fruit & Vegetable, Ginseng, Peanut, Pecan, and Macadamia Nut Producers | 0.00 | 0.00 | 268,170 | 4.000 | 1,072,680.00 | |||||||||||||||||||
| Handlers, Processors, & Wholesalers (except livestock processing & slaughtering) | 0.00 | 0.00 | 18,341 | 52.000 | 953,732.00 | 13141 | ||||||||||||||||||
| Livestock Processing & Slaughtering | 0.00 | 0.00 | 2,770 | 1040.000 | 2,880,800.00 | |||||||||||||||||||
| Retailers | 0.00 | 0.00 | 37,890 | 365.000 | 13,829,850.00 | |||||||||||||||||||
| Set-up and Maintenance (for Operations) | 0.00 | 0.00 | 0.00 | |||||||||||||||||||||
| Producers | 0.00 | 0.00 | 98,099 | 4.000 | 392,396.00 | -805,695 = number of 2016 producers (490497) minus number of 2013 producers (1296192) | ||||||||||||||||||
| Intermediaries -- Handlers, Processors, and Wholesalers | 0.00 | 0.00 | 4,222 | 29.000 | 122,438.00 | -1,573 = number of 2016 intermediaries (21111) minus number of 2013 intermediaries (22684) | ||||||||||||||||||
| Retailers | 0.00 | 0.00 | 1,023 | 29.000 | 29,667.00 | -8 = number of 2016 retailers (4504) minus number of 2013 retailers (4512) | ||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 652,842.00 | 21,949,487.00 | ||||||||||||||||||||
| TOTAL OF ALL PAGES | 0.00 | 0.00 | 652,842.00 | 21,949,487.00 | ||||||||||||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 652,842 | 21,949,487 | ||||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | ||||||||||||||||||||||
| 0581- | ||||||||||||||||||||||||
| DATE PREPARED | ||||||||||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | |||||||||||||||||||||||
| REPORTS | RECORDS | |||||||||||||||||||||||
| TOTAL | ||||||||||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | ||||||||||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | ||||||||||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | ||||||||||||||||
| RESPONDENT | KEEPER | |||||||||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | ||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| 0.00 | 0.00 | 0.00 | ||||||||||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | ||||||||||||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |