APPLICATION FOR EXEMPTION FROM SOCIAL SECURITY AND MEDICARE TAXES AND WAIVER OF BENEFITS

ICR 199107-1545-009

OMB: 1545-0064

Federal Form Document

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ICR Details
1545-0064 199107-1545-009
Historical Active 198902-1545-021
TREAS/IRS
APPLICATION FOR EXEMPTION FROM SOCIAL SECURITY AND MEDICARE TAXES AND WAIVER OF BENEFITS
Revision of a currently approved collection   No
Regular
Approved without change 10/22/1991
Retrieve Notice of Action (NOA) 07/29/1991
  Inventory as of this Action Requested Previously Approved
10/31/1994 10/31/1994 12/31/1991
3,754 0 8,216
3,942 0 8,873
0 0 0

FORM 4029 IS USED BY MEMBERS OF RECOGNIZED RELIGIOUS GROUPS TO APPLY FOR EXEMPTION FROM SOCIAL SECURITY AND MEDICARE TAXES UNDER IRC SECTIONS 1402(G) AND 3127 THE INFORMATION IS USED TO APPROVE OR DENY EXEMPTION FROM SOCIAL SECURITY AND MEDICARE TAXES.

None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR EXEMPTION FROM SOCIAL SECURITY AND MEDICARE TAXES AND WAIVER OF BENEFITS 4029

  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 3,754 8,216 0 -101 -4,361 0
Annual Time Burden (Hours) 3,942 8,873 0 -112 -4,819 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
07/29/1991


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