Burden Computation Worksheet

2018-8928-Burden-2018-06-28 16-37-33.pdf

Form 8928- Return of Certain Excise Taxes Under Chapter 43 & TD 9457-Employer Comparable Contributions to HSAs and Requirement for filing excise taxes under sections 4980B, 4980D, 4980E and 4980G.

Burden Computation Worksheet

OMB: 1545-2146

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Burden Computation - Business Forms
June 28, 2018

Product: 8928
OMB Number: 1545-2146
Description: Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code
Variables

Changes (+ -)

2018

Responses

100

100

Line Items

53

53

Attached Forms

2

Percent Paid Preparor
Code References

0.85

0.85

33

33

Computation of Changes
Old Computation (Prog. Change)

100

×

19.58

=

1,958

New Computation

100

×

23.48

=

2,348

=

390

Balance
Old Computation (Adjustment)

100

×

19.58

=

1,958

New Computation

100

×

19.58

=

2,348

Balance

=

Summary
Old Burden

1,958

Program Change

390

Adjustment
New Burden

23.48

Paperwork Reduction Act Notice
Time Per Response
23.48
Average Hours Per Response
Record Keeping

12.67

12 hrs. , 40 min.

Learning

4.01

4 hrs. , 00 min.

Preparing

6.25

6 hrs. , 15 min.

Sending

0.54

0 hrs. , 32 min.

Notes: No Changes to the burden estimates.


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