Information Collection

Statement For Claiming Benefits Provided By Section 911 Of The Internal Revenue Code

IC 130311 under ICR 199101-1545-004 · OMB 1545-0666.

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Information Collection (IC) Details

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IC Title:	STATEMENT FOR CLAIMING BENEFITS PROVIDED BY SECTION 911 OF THE INTERNAL REVENUE CODE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	673(IN)				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50,000	48,000	2,000
Annual IC Time Burden (Hours)	25,000	24,000	1,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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