| 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. | |||||||||||
| Commercial Transportation to Equines for Slaughter | 0579-0332 | ||||||||||||
| DATE PREPARED | |||||||||||||
| October 13, 2017 | |||||||||||||
| 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) | |||
| 88.2 | Business Information - Drivers of Transport Vehicles (Business) | 100 | 1.0 | 100 | 0.03 | 3 | 0 | ||||||
| 88.4(a)(3) | Owner/Shipper Certificate of Fitness to Travel to a Slaughter Facility (Business) | VS 10-13 | 170 | 15.0 | 2,550 | 0.50 | 1,275 | 0 | |||||
| 88.4(a)(3) | Individual | VS 10-13 | 30 | 15.0 | 450 | 0.50 | 225 | ||||||
| 88.4(a)(3) | Foreign Government (From 0579-0160) | VS 10-13 | 2 | 1500.0 | 3,000 | 0.10 | 300 | 0 | |||||
| 88.4(a)(3) | Owner/Shipper Certificate of Fitness to Travel to a Slaughter Facility Continuation Sheet (Business) | VS 10-13A | 170 | 15.0 | 2,550 | 0.50 | 1,275 | ||||||
| 88.4(a) | Individual | VS 10-13A | 30 | 15.0 | 450 | 0.50 | 225 | 0 | |||||
| 88.4(a)(3) | Foreign Government (From 0579-0160) | VS 10-13A | 2 | 1500.0 | 3,000 | 0.10 | 300 | 0 | |||||
| SUBTOTAL | 12,100 | 3,603 | 0.00 | 0 | |||||||||
| TOTAL OF ALL PAGES | 18,300 | 8,408 | 200.00 | 200 | |||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 18,500 | 8,608 | |||||||||||
| 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. | |||||||||||
| Commercial Transportation of Equines for Slaughter | 579-0332 | ||||||||||||
| DATE PREPARED | |||||||||||||
| October 13, 2017 | |||||||||||||
| 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) | |||
| 88.4 | Certificate of Veterinary Inspection (Business) | None | 200 | 16.0 | 3,200.0 | 1.50 | 4,800 | 0 | |||||
| 88.4(f) | Recordkeeping (Business) | 0.0 | 0 | 200 | 1.00 | 200 | |||||||
| 88.4(a)(2) | Application of backtags (Business) (third party discolsure) (From 0579-0160) | None | 200 | 15.0 | 3,000.0 | 0.0015 | 5 | 0 | |||||
| 0.0 | 0 | 0 | |||||||||||
| 0.0 | 0 | 0 | |||||||||||
| 0.0 | 0 | 0 | |||||||||||
| SUBTOTAL | 6,200.0 | 4,805 | 200 | 200 | |||||||||
| 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. | |||||||||||
| 0579- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display. |
TITLE OF INFORMATION COLLECTION DOCUMENT | OMB NO. | |||||||||||
| 0581- | |||||||||||||
| DATE PREPARED | |||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||
| REPORTS | RECORDS | ||||||||||||
| TOTAL | |||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||
| RESPONDENT | KEEPER | ||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |