| GIPSA Cost for Information Collection            Attachment 4 | 
		
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		| Form Number | 
		Title | 
		Total Annual Responses | 
		Average Time Response | 
		Total Hours per year | 
		GIPSA Hourly Cost* | 
		Program Cost | 
		Overhead Costs | 
		
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		| FGIS-904 | 
		Laboratory Scale Test | 
		2774 | 
		0.033 | 
		91.55 | 
		$26.02 | 
		$2,382.13 | 
		$331.12 | 
		
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		| FGIS-905 | 
		Official Sample-Lot Inspection Certificate | 
		
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		0.050 | 
		13.32 | 
		$21.28 | 
		$283.45 | 
		$39.40 | 
		
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		| FGIS-909 | 
		Export Certificate | 
		
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		0.050 | 
		39.10 | 
		$21.28 | 
		$831.98 | 
		$115.65 | 
		
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		| FGIS-913 | 
		Warehouseman's Sample Lot Inspection Certificate | 
		
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		0.050 | 
		1.56 | 
		$21.28 | 
		$33.20 | 
		$4.61 | 
		
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		| FGIS-914 | 
		Submitted Sample | 
		
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		0.050 | 
		19.04 | 
		$21.28 | 
		$405.17 | 
		$56.32 | 
		
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		| FGIS-915 | 
		Stowage Examination Certificate | 
		
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		0.050 | 
		55.19 | 
		$21.28 | 
		$1,174.44 | 
		$163.25 | 
		
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		| FGIS-921 | 
		Inspection Log | 
		691 | 
		1.000 | 
		691.08 | 
		$26.02 | 
		$17,981.90 | 
		$2,499.48 | 
		
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		| FGIS-921-2 | 
		Inspection Report -Insects | 
		1485 | 
		0.080 | 
		338.80 | 
		$26.02 | 
		$8,815.58 | 
		$1,225.37 | 
		
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		| FGIS-922 | 
		Inspection and Weighing Report | 
		672 | 
		0.167 | 
		112.22 | 
		$21.28 | 
		$2,388.04 | 
		$331.94 | 
		
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		| FGIS-923 | 
		Moisture Meter Test | 
		1160 | 
		0.033 | 
		38.28 | 
		$26.02 | 
		$996.05 | 
		$138.45 | 
		
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		| FGIS-924 | 
		Barley Pearler and Sieve Test | 
		976 | 
		0.033 | 
		32.21 | 
		$26.02 | 
		$838.10 | 
		$116.50 | 
		
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		| FGIS-925 | 
		Rice Checktest Form | 
		4 | 
		0.033 | 
		0.13 | 
		$26.02 | 
		$3.38 | 
		$0.47 | 
		
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		| FGIS-927 | 
		Testweight Checktest | 
		1586 | 
		0.033 | 
		52.34 | 
		$26.02 | 
		$1,361.89 | 
		$189.30 | 
		
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		| FGIS-928 | 
		Dockage Checktest | 
		848 | 
		0.033 | 
		27.98 | 
		$26.02 | 
		$728.04 | 
		$101.20 | 
		
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		| FGIS-930 | 
		AMA Output Report | 
		144 | 
		1.000 | 
		144.00 | 
		$21.28 | 
		$3,064.32 | 
		$425.94 | 
		
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		| FGIS-931 | 
		Approved Label for Insp. Machinery | 
		7182 | 
		0.033 | 
		237.01 | 
		$26.02 | 
		$6,167.00 | 
		$857.21 | 
		
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		| FGIS-936 | 
		Sampler Condition | 
		2667 | 
		0.083 | 
		221.37 | 
		$26.02 | 
		$5,760.05 | 
		$800.65 | 
		
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		| FGIS-938 | 
		Report of Grain Insp/Weighed Export | 
		520 | 
		0.083 | 
		43.16 | 
		$21.28 | 
		$918.44 | 
		$127.66 | 
		
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		| FGIS-952 | 
		Sanitation Inspection-Processed | 
		132 | 
		0.050 | 
		6.60 | 
		$26.02 | 
		$171.73 | 
		$23.87 | 
		
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		| FGIS-952-1 | 
		Sanitation Inspection-Pea, Beans, Lentils | 
		80 | 
		0.050 | 
		4.00 | 
		$26.02 | 
		$104.08 | 
		$14.47 | 
		
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		| FGIS-956 | 
		Rice Inspection Certificate | 
		
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		0.050 | 
		17.00 | 
		$21.28 | 
		$361.76 | 
		$50.28 | 
		
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		| FGIS-960 | 
		Grain Weight Certificate | 
		
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		0.050 | 
		3.74 | 
		$21.28 | 
		$79.59 | 
		$11.06 | 
		
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		| FGIS-963 | 
		Scale Record Log | 
		
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		0.050 | 
		8.50 | 
		$31.49 | 
		$267.67 | 
		$37.21 | 
		
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		| FGIS-964 | 
		Supervision of Weight Certificate | 
		
  | 
		0.050 | 
		42.08 | 
		$21.28 | 
		$895.55 | 
		$124.48 | 
		
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		| FGIS-965 | 
		Scale Test Report-Hopper | 
		186 | 
		0.083 | 
		15.44 | 
		$31.49 | 
		$486.21 | 
		$67.58 | 
		
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		| FGIS-965-1 | 
		Scale Test Report-Railroad Track | 
		14 | 
		0.083 | 
		1.16 | 
		$31.49 | 
		$36.53 | 
		$5.08 | 
		
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		| FGIS-965-2 | 
		Scale Test Report-Vehicle | 
		48 | 
		0.083 | 
		3.98 | 
		$31.49 | 
		$125.33 | 
		$17.42 | 
		
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		| FGIS-968 | 
		Weight Loading Log | 
		978 | 
		1.000 | 
		978.00 | 
		$26.02 | 
		$25,447.56 | 
		$3,537.21 | 
		
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		| FGIS-980 | 
		Authorization To Use Mechanical Sampler | 
		50 | 
		0.087 | 
		4.35 | 
		$31.49 | 
		$136.98 | 
		$19.04 | 
		
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		| FGIS-992 | 
		Services Performed Report | 
		8248 | 
		0.583 | 
		4808.58 | 
		$26.02 | 
		$125,119.25 | 
		$17,391.58 | 
		
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		| FGIS-993 | 
		Commodity Certificate | 
		
  | 
		0.050 | 
		17.00 | 
		$21.28 | 
		$361.76 | 
		$50.28 | 
		
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		| FGIS-994 | 
		Commodity Submitted Certificate | 
		
  | 
		0.050 | 
		83.20 | 
		$21.28 | 
		$1,770.50 | 
		$246.10 | 
		
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		| FGIS-998 | 
		Questionnaire for DT Sampler | 
		50 | 
		0.250 | 
		12.50 | 
		$31.49 | 
		$393.63 | 
		$54.71 | 
		
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		| None | 
		Fee Records | 
		25 | 
		2.000 | 
		50.00 | 
		$37.74 | 
		$1,887.00 | 
		$262.29 | 
		
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		| CP-2 | 
		License Sensory Examination | 
		100 | 
		0.167 | 
		33.40 | 
		$28.38 | 
		$947.89 | 
		$131.76 | 
		
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		| None | 
		Payment of Bills | 
		10200 | 
		0.083 | 
		846.60 | 
		$53.03 | 
		$44,895.20 | 
		$6,240.43 | 
		
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		| None | 
		Reporting Violations | 
		36 | 
		0.167 | 
		6.01 | 
		$37.74 | 
		$226.82 | 
		$31.53 | 
		
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		| None | 
		Work Records (AMA) | 
		6114 | 
		0.500 | 
		3057.00 | 
		$19.14 | 
		$58,510.98 | 
		$8,133.03 | 
		
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		| None | 
		Work Records (USGSA) | 
		1118768 | 
		0.083 | 
		92857.74 | 
		$19.14 | 
		$1,777,297.14 | 
		$247,044.30 | 
		
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		| *Step 5 of the GS schedule, rest of the US was used in calculations | 
		
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		$2,093,656.31 | 
		$291,018.23 | 
		
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		Grand Total                                                                                 | 
		
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		 $2,384,674.53  | 
		
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		| Only forms that incur a cost to GIPSA are included in this attachment. | 
		
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