2019 Burden-Form 4136 Line 4

Burden Computation - Business Forms
Page 1 of 1

July 21, 2015

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

4136/Line 4

2015

Changes (+ -)

2015

718,479
______________
15
______________
0.00
______________
0.85
______________
0
______________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

718,479
______________
15
______________
0.00
______________
0.85
______________
0
______________

Computation of Changes
718,479 x _____________
3.65
Old Computation (Prog. Change) ______________
718,479
3.65
New Computation.............. ______________ x _____________
Balance...

=
=

2,622,449
_______________
2,622,449
_______________
_______________
0

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

______________ x _____________
______________ x _____________

=
=

_______________
_______________
_______________

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

2,622,449
_______________
0
_______________
_______________
2,622,449
_______________

Paperwork Reduction Act Notice
Time Per Response
3.65
Recordkeeping.............
Learning..................
Preparing.................
Sending...................

Notes:

Average Hours
Per Response
3.59
______________
0.00
______________
0.06
______________
0.00
______________

Average Time
Per Response
3 hrs. , 35 min.
___________________
0 hrs. , 00 min.
___________________
0 hrs. , 03 min.
___________________
0 hrs. , 00 min.
___________________