Appendix D. OMB 0584-0303 275 regs burden chart

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Overview

OMB#0303 275 regs
Annualized Cst to States
ANnualized Cost to fEd Govt

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Sheet 1: OMB#0303 275 regs

APPENDIX D- BURDEN CHARTS
275 Regs Reporting OMB 0584-0303
Reg. Section	Affected Public	Description of Activity	Estimated Number of Respondents	Estimated responses per respondent	REVISED Total Annual responses	REVISED Number of Burden Hours Per Response	REVISED Estimated Total Burden Hours	Windows User: use these last 3 columns to reflect any decreases or increases. Previous Submission Total Hours	Difference Due to Program Changes	Difference Due to Adjustments
275.11(a)(1)-(a)(2)	State Agencies	Sampling Plan	53	1	53	7	371	265	0	106
275.2(c)(4)	State Agencies	Arbitration Process	12	3	36	34	1224	1512	0	432.09
273.23(f)	State Agencies	Good Cause Process	1	1	1	160	160	320	0	-160
275.23(h)	State Agencies	New Investment Plan Template Form FNS 74 A	9	1	9	32	288	128	0	160
275.23(h)(4)	State Agencies	New Investment Progress Report Template Form FNS 74 B	9	2	18	5	90	40	0	50
SUB-TOTAL REPORTING BURDEN			53	2.20754716981132	117	18.2307692307692	2133	2265	0	588.09
275 Recordkeeping OMB 0584-0303
275.4	State Agencies	Sampling Plan Record Retention	53	1	53	0.0236	1.2508	1.2508	0	0
275.4	State Agencies	Arbitration Process Record Retention	12	3	36	0.0236	0.8496	1.4868	0	-0.6372
275.4	State Agencies	Good Cause Process Record Retention	1	1	1	0.0236	0.0236	0.0472	0	-0.0236
275.4	State Agencies	New Investment Plan Template Form FNS 74 A Record Retention	9	1	9	0.0236	0.2124	0.0944	0	0.118
275.4	State Agencies	New Investment Progress Report Template Form FNS 74 B Record Retention	9	2	18	0.0236	0.4248	0.1888	0	0.236
Grand Total RECORDKEEPING			53	2.20754716981132	117	0.118	2.7612	3.068	0	-0.3068
Reg. Section	Affected Public	Description of Activity	Estimated Number of Respondents	Number of Reports Annually By State	Number of Total Annual Responses	Estimated Time Per Record	Estimated Total Record Keeping Hours	Windows User: use these last 3 columns to reflect any decreases or increases. Previous Submission Total Hours	Difference Due to Program Changes	Difference Due to Adjustments
Grand Total REPORTING & RECORDKEEPING			53	4.41509433962264	234	9.12718461538462	2135.7612	2268.068	0	-132.3068

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Sheet 2: Annualized Cst to States

Type of Respondent	Requirement	Responses Per Year	Hours Per Response	Wage-50% Cost Per Hour	Total Wage cost	Fring benefit increase (DxExF)+ (33%(DxExF))	Total Reporting Cost
State Agencies	Sampling Plan	53	7	$11.85	$4,394.50	$1,450.18	$5,844.68
State Agencies	Arbitration	36	34	$11.85	$14,498.28	$4,784.43	$19,282.71
State Agencies	Good Cause	1	160	$11.85	$1,895.20	$625.42	$2,520.62
State Agencies	New Investment Plan Form FNS 74 A	9	32	$11.85	$3,411.36	$1,125.75	$4,537.11
State Agencies	New Investment Plan Form FNS 74 B	18	5	$11.85	$1,066.05	$351.80	$1,417.85
Total Reporting Cost							$33,602.96
Type of Respondent	Requirement	Responses Per Year	Hours Per Response	Wage-50% Cost Per Hour	Total Wage cost	Fring benefit increase (DxExF)+ (33%(DxExF))	Total Reporting Cost
State Agencies	Sampling Plan	53	1.2508	$11.85	$785.23	$259.13	$1,044.36
State Agencies	Arbitration	36	0.8496	$11.85	$362.29	$119.55	$481.84
State Agencies	Good Cause	1	0.0236	$11.85	$0.28	$0.09	$0.37
State Agencies	New Investment Plan Form FNS 74 A	9	0.2124	$11.85	$22.64	$7.47	$30.12
State Agencies	New Investment Plan Form FNS 74 B	18	0.4248	$11.85	$90.57	$29.89	$120.46
Total Recordkeeping Cost							$1,677.15
							$35,280.11

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Sheet 3: ANnualized Cost to fEd Govt

Annualized cost to Fed Government
Estimates of Annualized Cost to Federal Government
Reporting and Recordkeeping Cost for FNS 275, OMB 0584-0303
Activities	Hours Spent on Collection	Costs or Hourly Wage Rage	Cost	Fringe Benefits Cost for Staff (0.33)	Overall Base Cost w/ Fringe Benefits for Staff
1. Printing Cost	N/A	$2,000.00	$2,000.00	N/A	$2,000.00
2. 50% Reimbursement Cost to States for reporting & recordkeeping administrative cost	N/A	$35,280.11		N/A	$35,280.11
Regional Office 275 Costs					$58,012.84
National Office 275 Costs					$57,981.50
Grand Total Cost to Government					$153,274.45
Requirement- Regional Offices	Total Responses Per Year	Hrs Per Response	Regional Office Respondents per Response	Regional Ofc Salary GS 11/2	Regional Office Salary Costs	Fringe benefits (33%)	TOTAL salary
Sampling Plan	53	24	1	$27.33	$34,763.76	$11,472.04	$46,235.80
Arbitration	36	5	1	$27.33	$4,919.40	$1,623.40	$6,542.80
Good Cause	1	0	0	$27.33	$0.00	$0.00	$0.00
New Investment Plan Template Form FNS 74 A	9	8	1	$27.33	$1,967.76	$649.36	$2,617.12
New Investment Plan Template 74B	18	4	1	$27.33	$1,967.76	$649.36	$2,617.12
Total R.O Salary Costs					$43,618.68	$14,394.16	$58,012.84
Requirement- National Office	Total Responses Per Year	Hrs Per Response	National Office Respondents per Response	National Ofc Salary GS 12/2 (14/1 for arbitrator branch chief; 15/1 director)	National Office Base Salary Costs	Fringe benefits (33%)	TOTAL salary
Sampling Plan	53	0	0	$36.99	$0.00	$0.00	$0.00
Arbitration	36	18	1	$44.55	$28,868.40	$9,526.57	$38,394.97
Good Cause	1	50	4	$36.99	$7,398.00	$2,441.34	$9,839.34
New Investment Plan Form FNS 74 A	9	4	2	$36.99	$2,663.28	$878.88	$3,542.16
New Investment Plan Form FNS 74 B	18	1.5	1	$36.99	$998.73	$329.58	$1,328.31
a .Program Analyst GS 12 Step 6 Estimates of Annualized Cost to Federal Government for drafting, reviewing & approving ICR	1	80	1	$36.99	$2,959.20	$976.54	$3,935.74
b. Program Branch Chief Estimates of Annualized Cost to Federal Government for drafting, reviewing & approving ICR	1	10	1	$44.55	$445.50	$147.02	$592.52
c. Program Division Director Estimates of Annualized Cost to Federal Government for drafting, reviewing & approving ICR	1	5	1	$52.40	$262.00	$86.46	$348.46
Total N.O Salary Costs					$43,595.11	$14,386.39	$57,981.50