EMPLOYER'S STATEMENT TO SUPPORT CLAIM UNDER FEDERAL INSURANCE CONTRIBUTIONS ACT

ICR 198109-1545-162

OMB: 1545-0555

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1545-0555 198109-1545-162
Historical Active
TREAS/IRS
EMPLOYER'S STATEMENT TO SUPPORT CLAIM UNDER FEDERAL INSURANCE CONTRIBUTIONS ACT
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/17/1981
Retrieve Notice of Action (NOA) 09/24/1981
  Inventory as of this Action Requested Previously Approved
11/30/1984 11/30/1984
7,500 0 0
1,500 0 0
0 0 0

AN EMPLOYER IS REQUIRED TO ENSURE THAT THE EMPLOYEE'S SHARE OF FICA TAX IS PROPERLY ACCOUNTED FOR PRIOR TO CLAIMING A REFUND. WHEN THE REFUND CLAIM DOES NOT CONTAIN AN INDICATION THAT THIS REQUIREMENT HAS BEEN MET, WE PROVIDE FORM 5071 TO THE EMPLOYER TO OBTAIN THIS CERTIFICATION.

None
None


No

1
IC Title Form No. Form Name
EMPLOYER'S STATEMENT TO SUPPORT CLAIM UNDER FEDERAL INSURANCE CONTRIBUTIONS ACT 5071,, 5071 PR

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 7,500 0 0 0 7,500 0
Annual Time Burden (Hours) 1,500 0 0 0 1,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
09/24/1981


© 2024 OMB.report | Privacy Policy