Aphis 71

0282 71 20180919.xlsx

Importation of Peppers from the Republic of Korea

APHIS 71

OMB: 0579-0282

Document [xlsx]
Download: xlsx | pdf
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.







Importation of Peppers from the Republic of Korea 0579-0282




DATE PREPARED


September 19, 2018
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)
319.56.42(e) Phytosanitary Certificate and Declaration (foreign government) None 1 5 5 0.50 3


319.56.42(e) Phytosanitary Certificate and Declaration (business) None 1 5 5 0.50 3


319.56.42(a) Greenhouse registration (foreign government) (same respondents as phytosanitary certificate) None 1 1 1 0.50 1


319.56.42(a) Greenhouse registration (business) (same respondents as phytosanitary certificates-business) None 1 1 1 0.50 1


319.56.42(a) Inspections (foreign government) None 1 12 12 1.00 12


319.56.42(a) Inspections (business) (same respondent as greenhouse registration) None 1 12 12 1.00 12



SUBTOTAL


36
32



TOTAL OF ALL PAGES


37
33


TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c


37
33















































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.








0579-0282




DATE PREPARED


September 19, 2018
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)

Emergency Action Notification (business) PPQ 523 1 1 1 1.00 1


























































SUBTOTAL


1
1















































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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 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
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00





0
0

0.00

SUBTOTAL


0
0 0
0.00
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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