Burden

Burden Computation - Business Forms
Page 1 of 1

November 19, 2014

Product:
Description:
Variables
Responses.......
Line Items......
Attachments.....
Forms Prepared..
Code References.

990 (SCH H)/
Hospitals
2012

Changes (+ -)

2014

2,102
______________
400
______________
0.00
______________
0.85
______________
6
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

2,102
______________
400
______________
0.00
______________
0.85
______________
6
______________

Computation of Changes
2,102 x _____________
98.44
Old Computation (Prog. Change) ______________
2,102 x _____________
98.44
New Computation.............. ______________
Balance...

=
=

206,921
_______________
206,921
_______________
_______________
0

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

2,102 x _____________
98.44
______________
2,102 x _____________
98.44
______________

=
=

206,921
_______________
206,921
_______________
0
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

206,921
_______________
0
_______________
0
_______________
206,921
_______________

Paperwork Reduction Act Notice
Time Per Response
98.44
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
95.66
______________
0.59
______________
2.19
______________
0.00
______________

Average Time
Per Response
95 hrs. , 39 min.
___________________
0 hrs. , 35 min.
___________________
2 hrs. , 11 min.
___________________
0 hrs. , 00 min.
___________________