Information Collection

Statement For Recipient Of Certain Government Payments

IC 170101 under ICR 198305-1545-016 · OMB 1545-0120.

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Documents and Forms

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Document Name	Document Type

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IC Title:

STATEMENT FOR RECIPIENT OF CERTAIN GOVERNMENT PAYMENTS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1099-G				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	77,940,774	-10,000	77,950,774
Annual IC Time Burden (Hours)	2,373,168	-285	2,373,453
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.