WORKSHEET TO DETERMINE WITHHOLDING ALLOWANCES

Forms and Documents

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Collection	Type	Status	Form
129770	WORKSHEET TO DETERMINE WITHHOLDING ALLOWANCES	Form	Migrated

ICR Details

OMB Control No: 1545-0363	ICR Reference No: 198212-1545-009
Status: Historical Active	Previous ICR Reference No: 198201-1545-002
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: WORKSHEET TO DETERMINE WITHHOLDING ALLOWANCES
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/1982
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/14/1982
Terms of Clearance: end REQUEST TO EXTEND THE USE OF THIS FORM TO SUBSEQUENT TAX YEARS SHOULD INCLUDE A REPORT ON THE NUMBER OF THESE FORMS SUBMITTED DURING TAX YEA 1982, THE NUMBER OF CHANGES IN THE ALLOWABLE WITHHOLDING CLAIMS MADE AS A RESULT OF THESE SUBMISSIONS, AND AN ESTIMATE OF THE RESULTING IMPACT ON THE REVENUES.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1985	12/31/1985	12/31/1983
Responses	275,000	0	80,000
Time Burden (Hours)	371,250	0	100,000
Cost Burden (Dollars)	0	0	0

---

Abstract: FORM 6355 IS USED IN CONJUNCTION WITH LETTER 1380(SC/DO) TO CONTACT EMPLOYEES WHO FILED NON-EXEMPT FORMS W-4. THE IRS USES THIS INFORMATION TO DETERMINE THE NUMBER OF WITHHOLDING ALLOWANCES THE EMPLOYEE IS ENTITLED TO CLAIM.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
WORKSHEET TO DETERMINE WITHHOLDING ALLOWANCES	6355

---

ICR Summary of Burden

	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	275,000	80,000	0	0	195,000	0
Annual Time Burden (Hours)	371,250	100,000	0	0	271,250	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/14/1982

---