| 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 | 
		$27.02 | 
		$2,473.68 | 
		$343.84 | 
		
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		| FGIS-905 | 
		Official Sample-Lot Inspection Certificate | 
		
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		0.050 | 
		13.32 | 
		$22.09 | 
		$294.24 | 
		$40.90 | 
		
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		| FGIS-909 | 
		Export Certificate | 
		
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		0.050 | 
		39.10 | 
		$22.09 | 
		$863.65 | 
		$120.05 | 
		
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		| FGIS-913 | 
		Warehouseman's Sample Lot Inspection Certificate | 
		
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		0.050 | 
		1.56 | 
		$22.09 | 
		$34.46 | 
		$4.79 | 
		
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		| FGIS-914 | 
		Submitted Sample | 
		
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		0.050 | 
		19.04 | 
		$22.09 | 
		$420.59 | 
		$58.46 | 
		
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		| FGIS-915 | 
		Stowage Examination Certificate | 
		
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		0.050 | 
		55.19 | 
		$22.09 | 
		$1,219.15 | 
		$169.46 | 
		
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		| FGIS-921 | 
		Inspection Log | 
		691 | 
		1.000 | 
		691.08 | 
		$27.02 | 
		$18,672.98 | 
		$2,595.54 | 
		
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		| FGIS-921-2 | 
		Inspection Report -Insects | 
		1485 | 
		0.080 | 
		338.80 | 
		$27.02 | 
		$9,154.38 | 
		$1,272.46 | 
		
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		| FGIS-922 | 
		Inspection and Weighing Report | 
		672 | 
		0.167 | 
		112.22 | 
		$22.09 | 
		$2,478.94 | 
		$344.57 | 
		
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		| FGIS-923 | 
		Moisture Meter Test | 
		1160 | 
		0.033 | 
		38.28 | 
		$27.02 | 
		$1,034.33 | 
		$143.77 | 
		
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		| FGIS-924 | 
		Barley Pearler and Sieve Test | 
		976 | 
		0.033 | 
		32.21 | 
		$27.02 | 
		$870.31 | 
		$120.97 | 
		
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		| FGIS-925 | 
		Rice Checktest Form | 
		4 | 
		0.033 | 
		0.13 | 
		$27.02 | 
		$3.51 | 
		$0.49 | 
		
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		| FGIS-927 | 
		Testweight Checktest | 
		1586 | 
		0.033 | 
		52.34 | 
		$27.02 | 
		$1,414.23 | 
		$196.58 | 
		
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		| FGIS-928 | 
		Dockage Checktest | 
		848 | 
		0.033 | 
		27.98 | 
		$27.02 | 
		$756.02 | 
		$105.09 | 
		
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		| FGIS-930 | 
		AMA Output Report | 
		144 | 
		1.000 | 
		144.00 | 
		$22.09 | 
		$3,180.96 | 
		$442.15 | 
		
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		| FGIS-931 | 
		Approved Label for Insp. Machinery | 
		7182 | 
		0.033 | 
		237.01 | 
		$27.02 | 
		$6,404.01 | 
		$890.16 | 
		
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		| FGIS-936 | 
		Sampler Condition | 
		2667 | 
		0.083 | 
		221.37 | 
		$27.02 | 
		$5,981.42 | 
		$831.42 | 
		
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		| FGIS-938 | 
		Report of Grain Insp/Weighed Export | 
		520 | 
		0.083 | 
		43.16 | 
		$22.09 | 
		$953.40 | 
		$132.52 | 
		
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		| FGIS-952 | 
		Sanitation Inspection-Processed | 
		132 | 
		0.050 | 
		6.60 | 
		$27.02 | 
		$178.33 | 
		$24.79 | 
		
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		| FGIS-952-1 | 
		Sanitation Inspection-Pea, Beans, Lentils | 
		80 | 
		0.050 | 
		4.00 | 
		$27.02 | 
		$108.08 | 
		$15.02 | 
		
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		| FGIS-956 | 
		Rice Inspection Certificate | 
		
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		0.050 | 
		17.00 | 
		$22.09 | 
		$375.53 | 
		$52.20 | 
		
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		| FGIS-960 | 
		Grain Weight Certificate | 
		
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		0.050 | 
		3.74 | 
		$22.09 | 
		$82.62 | 
		$11.48 | 
		
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		| FGIS-963 | 
		Scale Record Log | 
		
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		0.050 | 
		8.50 | 
		$22.09 | 
		$187.77 | 
		$26.10 | 
		
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		| FGIS-964 | 
		Supervision of Weight Certificate | 
		
  | 
		0.050 | 
		42.08 | 
		$22.09 | 
		$929.64 | 
		$129.22 | 
		
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		| FGIS-965 | 
		Scale Test Report-Hopper | 
		186 | 
		0.083 | 
		15.44 | 
		$32.70 | 
		$504.89 | 
		$70.18 | 
		
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		| FGIS-965-1 | 
		Scale Test Report-Railroad Track | 
		14 | 
		0.083 | 
		1.16 | 
		$32.70 | 
		$37.93 | 
		$5.27 | 
		
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		| FGIS-965-2 | 
		Scale Test Report-Vehicle | 
		48 | 
		0.083 | 
		3.98 | 
		$32.70 | 
		$130.15 | 
		$18.09 | 
		
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		| FGIS-968 | 
		Weight Loading Log | 
		978 | 
		1.000 | 
		978.00 | 
		$27.02 | 
		$26,425.56 | 
		$3,673.15 | 
		
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		| FGIS-980 | 
		Authorization To Use Mechanical Sampler | 
		50 | 
		0.087 | 
		4.35 | 
		$32.70 | 
		$142.25 | 
		$19.77 | 
		
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		| FGIS-992 | 
		Services Performed Report | 
		8248 | 
		0.583 | 
		4808.58 | 
		$27.02 | 
		$129,927.83 | 
		$18,059.97 | 
		
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		| FGIS-993 | 
		Commodity Certificate | 
		
  | 
		0.050 | 
		17.00 | 
		$22.09 | 
		$375.53 | 
		$52.20 | 
		
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		| FGIS-994 | 
		Commodity Submitted Certificate | 
		
  | 
		0.050 | 
		83.20 | 
		$22.09 | 
		$1,837.89 | 
		$255.47 | 
		
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		| FGIS-998 | 
		Questionnaire for DT Sampler | 
		50 | 
		0.250 | 
		12.50 | 
		$32.70 | 
		$408.75 | 
		$56.82 | 
		
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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 | 
		$55.07 | 
		$46,622.26 | 
		$6,480.49 | 
		
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		| None | 
		Reporting Violations | 
		36 | 
		0.167 | 
		6.01 | 
		$39.19 | 
		$235.53 | 
		$32.74 | 
		
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		| None | 
		Work Records (AMA) | 
		6114 | 
		0.500 | 
		3057.00 | 
		$19.88 | 
		$60,773.16 | 
		$8,447.47 | 
		
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		| None | 
		Work Records (USGSA) | 
		1118768 | 
		0.083 | 
		92857.74 | 
		$19.88 | 
		$1,846,011.87 | 
		$256,595.65 | 
		
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		| *Step 5 of the GS schedule, rest of the US was used in calculations | 
		
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		$2,174,340.71 | 
		$302,233.36 | 
		
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		Grand Total                                                                                 | 
		
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		 $2,476,574.07  | 
		
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		| Only forms that incur a cost to GIPSA are included in this attachment. | 
		
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