Appendix B - Burden Table

Appendix B - Burden Table for 0584-0614
Respondent Category	Type of respondents (optional)	Instruments	Form	Number of respondents	Frequency of response	Total Annual responses	Hours per response	Annual burden (hours)	Hourly Wage Rate	Total Annualized Cost of Respondent Burden
(A) 3 Categories: - Individual / Household - State/ Local/ Tribal Government - Business (Profit, Non-Profit, or Farm)	(B) Describe the respondent. (optional)	(C) Description or Name of Instrument. For rules, this will be the CFR citation.	(E) Form Number, where applicable	(F) Number of unique persons estimated to respond	(G) Number of times per year the respondent will respond to each instrument	(H) (= F x G) Total responses per year for each instrument	(I) Average Time (in hours) it will take each person to respond to the instrument. To convert minutes to hours, divide minutes by 60.	(J) (= H x I) Average total time (in hours) it will take all respondents to respond.	(Q) BLS Hourly Wage. Use a wage rate that best fits the respondent.	(R) = Hourly Wage Rate (Q) x Total Burden (P)
State Government		272.1(f)		53	1	53	1	53.0	$50.89	$2,697.17
State Government		273.7(c-)(17)(i)		53	1	53	40	2120	$50.89	$107,886.80
State Government		273.7(c-)(17)(ii)		53	1	53	40	2120	$50.89	$107,886.80
State Government		273.7(c-)(17)(iii)		53	1	53	40	2120	$50.89	$107,886.80
State Government		273.7(c-)(17)(iv)		45	1	45	80	3600	$50.89	$183,204.00
State Government		273.7(c-)(17)(v) & (vi)		53	1	53	20	1060	$50.89	$53,943.40
State Government		273.7(c-)(17)(vii)		53	1	53	20	1060	$50.89	$53,943.40
State Government		273.7(c-)(17)(viii)		10	1	10	10	100	$50.89	$5,089.00
	TOTAL			53	1.000	373	32.796	12,233		$622,537.37