| Appendix D |
| WIC and WIC FMNP Waiver Burden Table - OMB# 0584-NEW |
| Affected Public |
Instruments |
Est. No. of Respondents |
No. of Responses per Respondent |
Total Annual Responses |
Est. Total Hours per Response |
Est. Total Burden |
Hourly Wage Rate |
Total Annualized Cost of Respondent Burden |
| ARPA |
|
|
| WIC State Program Staff |
Accelerated waivers |
56 |
4 |
224 |
0.17 |
37.41 |
$31.28 |
$1,170.12 |
| WIC State Program Staff |
Waivers requiring additional information |
56 |
5 |
280 |
1 |
280.00 |
$31.28 |
$8,758.40 |
| WIC State Program Staff |
Ad hoc waivers |
7 |
1 |
7 |
2 |
14.00 |
$31.28 |
$437.92 |
| WIC FMNP State Program Staff |
Accelerated waivers |
44 |
4 |
176 |
0.17 |
29.39 |
$31.28 |
$919.38 |
| WIC FMNP State Program Staff |
Waivers requiring additional information |
44 |
5 |
220 |
1 |
220.00 |
$31.28 |
$6,881.60 |
| WIC FMNP State Program Staff |
Ad hoc waivers |
3 |
1 |
3 |
2 |
6.00 |
$31.28 |
$187.68 |
| Subtotal State ARPA Reporting |
100 |
9.1 |
910 |
0.64 |
586.80 |
|
$18,355.10 |
| WIC ITO Program Staff |
Accelerated waivers |
33 |
4 |
132 |
0.17 |
22.04 |
$31.28 |
$689.54 |
| WIC ITO Program Staff |
Waivers requiring additional information |
33 |
5 |
165 |
1 |
165.00 |
$31.28 |
$5,161.20 |
| WIC ITO Program Staff |
Ad hoc waivers |
3 |
1 |
3 |
2 |
6.00 |
$31.28 |
$187.68 |
| WIC FMNP ITO Program Staff |
Accelerated waivers |
7 |
4 |
28 |
0.17 |
4.68 |
$31.28 |
$146.27 |
| WIC FMNP ITO Program Staff |
Waivers requiring additional information |
7 |
5 |
35 |
1 |
35.00 |
$31.28 |
$1,094.80 |
| WIC FMNP ITO Program Staff |
Ad hoc waivers |
2 |
1 |
2 |
2 |
4.00 |
$31.28 |
$125.12 |
| Subtotal Indian Tribal Organization (ITO) ARPA Reporting |
40 |
9.13 |
365 |
0.65 |
236.72 |
|
$7,404.60 |
| Subtotal ARPA Reporting |
140 |
9.11 |
1275 |
0.65 |
823.52 |
|
$25,759.71 |
| ABFA |
|
|
| WIC State Program Staff |
Waiver request form |
7 |
3 |
21 |
0.25 |
5.25 |
$31.28 |
$164.22 |
| WIC ITO Program Staff |
Waiver request form |
3 |
3 |
9 |
0.25 |
2.25 |
$31.28 |
$70.38 |
| Subtotal ABFA Reporting |
10 |
3 |
30 |
0.25 |
7.5 |
|
$234.60 |
| Grand total Reporting Burden |
140 |
9.11 |
1275 |
0.65 |
831.02 |
|
$25,994.31 |