| 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-83-1: 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. | |||||||||||||||
| Citrus Greening & Asian Citrus Psyllid, Quarantine & Interstate Movement Regulations-APHIS-2008-0015 | 0579- | ||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 301.76-5 | Federal Certificate (business) | PPQ 540 | 5 | 52.0000 | 260.00 | 0.2000 | 52.00 | 0.00 | |||||||||
| 301.76-5 | Limited Permit (business) | PPQ 530 | 49 | 14.0000 | 686.00 | 0.2000 | 137.20 | 0.00 | #NAME? | ||||||||
| 301.76-5 | Compliance Agreement (business) | PPQ 519 | 49 | 1.0000 | 49.00 | 1.2500 | 61.25 | 0.00 | |||||||||
| 301.76-4 | Label statement (business) | none | 13 | 146153.0000 | 1,899,989.00 | 0.0001 | 190.00 | 0.00 | |||||||||
| 301-76-8 | Record Keeping (business) same respondents | none | 0.00 | 0.00 | 49 | 0.008 | 1.00 | ||||||||||
| 301-76-8 | Attach tag to consignee's copy of accompanying waybill (business) (same respondents) | none | 49 | 14.0000 | 686.00 | 0.0083 | 5.69 | 0.00 | |||||||||
| SUBTOTAL | 116 | 1,901,670.00 | 446.14 | 1.00 | 1.00 | ||||||||||||
| TOTAL OF ALL PAGES | 116 | 1,902,356.00 | 503.08 | 1.00 | 1.00 | ||||||||||||
| TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c | 1,902,357.00 | 504.08 | |||||||||||||||
| 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-83-1: 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. | |||||||||||||||
| Citrus Greening & Asian Citrus Psyllid, Quarantine & Interstate Movement Regulations, APHIS-2008-0015 | 0579- | ||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 301-76-8 | Cancellation of Certificates, Permits & Compliance Agreements (none expected at this time and none expected during the year) (business) | none | 0.00 | 0.00 | 0.00 | ||||||||||||
| 301-76-9 | 72-Hour Notification of Inspection (business) (same respondents) | none | 49 | 14.0000 | 686.00 | 0.0830 | 56.94 | 0.00 | |||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 686.00 | 56.94 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 301-76-8 | cancellation of Certificates, Permits & Compliance Agreements (business) | none | 0.00 | 0.00 | 0.00 | ||||||||||||
| 301-76-9 | 72-Hour Notification of Inspection | none | 0.00 | 0.00 | 0.00 | ||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| 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-83-1: 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. | |||||||||||||||
| 0581- | |||||||||||||||||
| DATE PREPARED | |||||||||||||||||
| IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT | ANNUAL BURDEN | ||||||||||||||||
| REPORTS | RECORDS | ||||||||||||||||
| TOTAL | |||||||||||||||||
| FORMS NO (S) | NO. OF | NO OF | TOTAL ANNUAL | HOURS | TOTAL | NO. OF | ANNUAL | RECORD- | |||||||||
| SECTION OF | DESCRIPTION | (If "none" | RESPONDENTS | RESPONSES | RESPONSES | PER | HOURS | RECORD- | HOURS PER | KEEPING HOURS | |||||||
| REGS. | so state) | PER | (Col. D x E) | RESPONSE | (Col. F x G) | KEEPERS | RECORD- | (Col. I x J) | |||||||||
| RESPONDENT | KEEPER | ||||||||||||||||
| (A) | (B) | (C) | (D) | (E) | (F) | (G) | (H) | (I) | (J) | (K) | |||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| 0.00 | 0.00 | 0.00 | |||||||||||||||
| SUBTOTAL | 0.00 | 0.00 | 0 | 0.00 | |||||||||||||
| File Type | application/vnd.ms-excel |
| Author | user |
| File Modified | 2009-08-21 |
| File Created | 2000-01-10 |