Burden Spreadsheet

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-I: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.								TITLE OF INFORMATION COLLECTION DOCUMENT					OMB NO.
													0596-
													DATE PREPARED
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT							ANNUAL BURDEN
							REPORTS					RECORDS			RESPONDENT COST
														TOTAL
						FORMS NO (S)	NO. OF	NO OF	TOTAL ANNUAL	HOURS	TOTAL	NO. OF	ANNUAL	RECORD-	COST	TOTAL
SECTION OF	DESCRIPTION					(If "none"	RESPONDENTS	RESPONSES	RESPONSES	PER	HOURS	RECORD-	HOURS PER	KEEPING HOURS	PER	COST
REGS.						so state)		PER	(Col. D x E)	RESPONSE	(Col. F x G)	KEEPERS	RECORD-	(Col. I x J)	HOUR	(Col. H x L)
								RESPONDENT					KEEPER
(A)	(B)					(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)	(K)	(L)	(M)
						FS=2200-001	91	1.00	91.00	0.333	30.33	30	1.000	30.00	36.93	$1,120.21
						FS=2200-002	85	1.00	85.00	0.333	28.33	28	1.000	28.00	36.93	$1,046.35
						FS=2200-012	135	1.0000	135.00	0.5000	67.50	68	1.000	68.00	36.93	$2,492.78
						FS=2200-013	61	1.0000	61.00	0.3333	20.33	20	1.000	20.00	36.93	$750.91
						FS=2200-016	679	1.0000	679.00	0.5000	339.50	340	1.000	340.00	36.93	$12,537.74
						FS=2200-017	51	1.0000	51.00	0.3333	17.00	17	1.000	17.00	36.93	$627.81
						FS=2200-025	441	1.0000	441.00	0.1667	73.50	74	1.000	74.00	36.93	$2,714.36
	SUBTOTAL								1543		577	577.00		577.00		$21,290.15
	TOTAL OF ALL PAGES						1,543		1543		577	577.00		577.00		$21,290.15
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c									2,120.00		1,153.50