| 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. | |||||||||||||||||
| Irradiation Phytosanitary Treatment of Imported Fruits and Vegetables | 0579-0155 | ||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||
| February 29, 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) | |||||||||
| 305.9 c (ii) | Compliance Agreement - (business) | PPQ 519 | 6 | 1.00 | 6.0 | 1.25 | 8 | 0.00 | |||||||||||
| 305.9 (e) (2) | 30 Day Notification (Business) | None | 10 | 10.00 | 100.0 | 0.05 | 5 | 0.00 | |||||||||||
| 305.9 (e) (2) | 30 Day Notification (Foreign Government) | None | 5 | 10.00 | 50.0 | 0.08 | 4 | 0.00 | |||||||||||
| 305.9 (f) | Labeling/Packaging - (business) | None | 40 | 1000.00 | 40,000.0 | 0.00 | 20 | 0.00 | |||||||||||
| 305.9(j) | Dosimetry Systems at the Irradiation Facility- (business) | None | 15 | 8.00 | 120.0 | 0.08 | 10 | 0.00 | |||||||||||
| 305.9(j) | Request for approval for dosimetry device - (business) *same respondents as dosimetry systems | None | 15 | 1.00 | 15.0 | 0.25 | 4 | 0.00 | |||||||||||
| SUBTOTAL | 40,291.0 | 51 | 0.00 | 0.00 | |||||||||||||||
| TOTAL OF ALL PAGES | 63 | 40,419.0 | 346 | 15.00 | 1.00 | ||||||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 40,434.0 | 347 | |||||||||||||||||
| 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. | |||||||||||||||||
| Irradiation Phytosanitary Treatment of Imported Fruits and Vegetables | 0579-0155 | ||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||
| February 29, 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) | |||||||||
| 305.9 (k) | Recordkeeping - (business) | None | 0.0 | 0 | 15 | 0.066 | 1.00 | 0 | |||||||||||
| 305.9(k) (1) | Request for Certification and Inspection of Facility - (business) | None | 8 | 4.00 | 32.0 | 0.25 | 8 | 0.00 | |||||||||||
| 305.9(e)(1) | Irradiation Treatment Framework Equivalency Work Plan - (Foreign Government) | None | 8 | 1.00 | 8.0 | 0.50 | 4 | 0.00 | |||||||||||
| 305.9(e) (2) (i) | Facility Preclearance Work Plan - (Foreign Government) | None | 4 | 6.00 | 24.0 | 0.50 | 12 | 0.00 | |||||||||||
| 305.9(e) (2) (ii) | Trust Fund Agreement (Foreign Government) | None | 3 | 1.00 | 3.0 | 80.00 | 240 | 0.00 | |||||||||||
| 305.9(h) | Phytosanitary Certificate - (Foreign Government) | None | 1 | 30.00 | 30.0 | 0.50 | 15 | 0.00 | |||||||||||
| SUBTOTAL | 97.0 | 279 | 15 | 1.00 | |||||||||||||||
| 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. | |||||||||||||||||
| Irradiation Phytosanitary Treatment of Imported Fruits and Vegetables | 0579-0155 | ||||||||||||||||||
| DATE PREPARED | |||||||||||||||||||
| February 29, 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) | |||||||||
| 305.9(h) | Phytosanitary Certificate - (business) | None | 5 | 6.00 | 30.0 | 0.50 | 15 | 0 | |||||||||||
| 305.9(m) | Denial and Withdrawal of Certification - (business) | None | 1 | 1.00 | 1.0 | 0.25 | 1 | 0 | |||||||||||
| 0.0 | 0 | 0 | |||||||||||||||||
| 0.0 | 0 | 0 | |||||||||||||||||
| 0.0 | 0 | 0 | |||||||||||||||||
| 0.0 | 0 | 0 | |||||||||||||||||
| SUBTOTAL | 31.0 | 16 | 0 | 0 | |||||||||||||||
| 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 |