| Attachment B |
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OMB #: |
0584-0339 |
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| Reporting |
| Respondent Category |
Type of respondents (optional) |
Number of respondents |
Frequency of response |
Total Annual responses |
Hours per response |
Annual burden (hours) |
Hourly Wage Rate, incl fringe benefits |
Total Annualized Cost of Respondent Burden |
| State Government |
State Program Staff |
18 |
1 |
18 |
1 |
18.0 |
$25.06 |
$451.03 |
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TOTAL Reporting |
18 |
1.000 |
18 |
1.000 |
18 |
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$451.03 |
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| Recordkeeping |
| Respondent Category |
Type of respondents (optional) |
Number of respondents |
Frequency of response |
Total Annual responses |
Hours per response |
Annual burden (hours) |
Hourly Wage Rate, incl fringe benefits |
Total Annualized Cost of Respondent Burden |
| State Government |
State Program Staff |
18 |
1 |
18 |
0.137 |
2.47 |
$25.06 |
$61.79 |
| State Government |
State Program Staff |
53 |
4 |
212 |
0.137 |
29.04 |
$25.06 |
$727.76 |
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TOTAL Recordkeeping |
53 |
4.340 |
230 |
0.137 |
31.51 |
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$789.55 |
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| Total All Burdens Summary |
| Summary |
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Est. No. of Respondents |
No. of Reponses per Respondent |
Total Annual Responses |
Est. Total hours per Response |
Est. Total Burden |
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Est. Total Annualized Cost of Respondent Burden |
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Reporting |
18 |
1 |
18 |
1.000 |
18.00 |
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$451.03 |
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Recordkeeping |
53 |
4.340 |
230 |
0.1370 |
31.51 |
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$789.55 |
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Total |
53 |
4.679 |
248 |
0.1996 |
49.51 |
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$1,240.58 |