Appendix B 0608 Burden Table

Regulation	Burden Activity	Estimated Number of Respondents	Estimated Responses per Respondent	Estimated Total Annual Responses	Estimated Hours per Response	Estimated Total Annual Hours	Hourly Cost to Respondent	Estimated Cost to Respondent	Fully Loaded Wages	Previously Approved under 0584-0608	Difference Due to Program Changes	Difference Due to Adjustment	OMB# 0584-0608
State Agency Reporting Burden													Exp: xx-xx-xxxx
272.2	Program Activity Statement	0	0	0	0	0	$-	0	0	0	0	0
272.16	NDNH - Applicant/Recipient Screening	53	147,162.75	7,799,626.00	0.0501	390,761.26	$11.33	$4,425,371.30	$5,885,743.83	155,690.08	0	235,071.18
272.16	NDNH - Verification of Match	53	19,886.85	1,054,003.00	0.0668	70,407.40	$11.33	$797,363.81	$1,060,493.87	37,128.00	0	33,279.40
272.16	NDND - Notice of Adverse Action or Notice of Denial	53	7,954.74	421,601.20	0.0501	21,122.22	$11.33	$239,209.14	$318,148.16	14,851.00	0	6,271.22
State Agency Total		53	175,004.34	9,275,230.20	0.051997726495241	482,290.88	$11.33	$5,461,944.25	$7,264,385.85	207,669.08		274,621.80
Household Reporting Burden
272.16	NDNH - Response to Request for Contact	758,882.00	1.00	758,882.00	0.0334	25,346.66	$7.25	$183,763.28		26,732.16	0	-1,385.50
272.16	NDNH - Response to Notice of Adverse Action or Notice of Denial	421,601.20	1.00	421,601.20	0.0334	14,081.48	$7.25	$102,090.73		14,851.20	0	-769.72
Household Reporting Total		1,180,483.20	1	1,180,483.20	0.0334	39,428.14	$7.25	$285,854.01	$-	41,583.36		-2,155.22
Grand Totals		1,180,536.20	8.8567495007777	10,455,713.40	0.049897984196851	521,719.02		$5,747,798.26	$7,550,239.86	249,252.44
				$7,265,114.81	$14,528,771.71