THIS FORM IS THE EXISTING IRS
QUARTERLY RETURN OF WITHHELD FEDERAL INCOME TAX. AT THE CENSUS
BUREAU'S REQUEST, AN EMPLOYMENT QUESTION HAS BEEN ADDED TO THE 1ST
QUARTER REPORT ONLY TO PROVIDE COMMON DATA FOR TAX EXEMPT
ORGANIZATIONS AND PENSION AND ANNUITIES. DATA TO BE INCLUDED IN THE
SSEL (SEE 41R2751), AND PUBLISHED ANNUALLY IN COUNTY BUSINESS
PATTERN PUBLICATIONS.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.