EMPLOYEE WAGE STATEMENT

ICR 198303-1545-025

OMB: 1545-0364

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
129772 Migrated
ICR Details
1545-0364 198303-1545-025
Historical Active 198108-1545-153
TREAS/IRS
EMPLOYEE WAGE STATEMENT
Extension without change of a currently approved collection   No
Regular
Approved without change 04/12/1983
Retrieve Notice of Action (NOA) 03/30/1983
  Inventory as of this Action Requested Previously Approved
04/30/1986 04/30/1986 06/30/1983
72,000 0 72,000
18,000 0 18,000
0 0 0

FORM 4669 IS COMPLETED BY AN EMPLOYEE CERTIFYING THAT HE/SHE HAS REPORTED CERTAIN WAGES RECEIVED FROM AN EMPLOYER. THIS FORM IS SENT BY THE EMPLOYER TO THE IRS IN ORDER TO ABATE ANY INCOME TAX WITHHOLDIN ASSESSED AGAINST THE EMPLOYER. THE DATA IS USED TO VERIFY THAT THE INCOME TAX ON THE WAGES WAS PAID IN FULL.

None
None


No

1
IC Title Form No. Form Name
EMPLOYEE WAGE STATEMENT 4669

  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 72,000 72,000 0 0 0 0
Annual Time Burden (Hours) 18,000 18,000 0 0 0 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.
03/30/1983


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