ABLE Account Contribution Information

Burden Computation - Special Business Forms
Page 1 of 1

April 15, 2015

Product:
Description:

5498-QA/
ABLE Account Contribution Information

Variables
Responses.......
Line Items......
Forms Prepared..

______________
______________
______________

Changes (+ -)

2015

+10,000
_____________________________
+12
_____________________________
+0.85
_____________________________

10,000
______________
12
______________
0.85
______________

Computation of Changes
10,000 x _____________
Old Computation (Prog. Change) ______________
10,000 x _____________
0.19
New Computation.............. ______________
Balance...

=
=

_______________
1,900
_______________
+1,900
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

_______________
+1,900
_______________
_______________
1,900
_______________

Paperwork Reduction Act Notice
Time Per Response
0.19
Record Keeping............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
______________
______________
______________
0.19
______________

Average Time
Per Response
___________________
___________________
___________________
0 hrs. , 11 min.
___________________