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pdfBurden Computation - Business Forms
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May 15, 2014
Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.
8849 (SCH 6)/
Other Claims
2013
Changes (+ -)
2014
5,300
______________
9
______________
1.00
______________
0.85
______________
3
______________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
5,300
______________
9
______________
1.00
______________
0.85
______________
3
______________
Computation of Changes
5,300 x _____________
4.75
Old Computation (Prog. Change) ______________
5,300 x _____________
4.75
New Computation.............. ______________
Balance...
=
=
25,175
_______________
25,175
_______________
_______________
0
Old Computation (Adjustment).
New Computation..............
Balance...
______________ x _____________
______________ x _____________
=
=
_______________
_______________
_______________
Old Computation..............
New Computation..............
Balance...
______________ x _____________
______________ x _____________
=
=
_______________
_______________
_______________
Summary
Old Burden...................................................
Program Change...............................................
Adjustment...................................................
New Burden...................................................
25,175
_______________
0
_______________
_______________
25,175
_______________
Paperwork Reduction Act Notice
Time Per Response
4.75
Recordkeeping.............
Learning..................
Preparing.................
Sending...................
Notes:
Average Hours
Per Response
2.15
______________
0.67
______________
1.66
______________
0.27
______________
Average Time
Per Response
2 hrs. , 09 min.
___________________
0 hrs. , 40 min.
___________________
1 hrs. , 39 min.
___________________
0 hrs. , 16 min.
___________________
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