Approved with
the revision to the instructions for line 14 which was received on
October 21st. Remarks added, eff. 07/25/94: You may omit printing
the expiration date on this form.
Inventory as of this Action
Requested
Previously Approved
10/31/1996
10/31/1996
10/31/1994
2,395,000
0
2,435,000
7,927,450
0
7,834,200
0
0
0
FORM 1040X IS USED BY INDIVIDUALS TO
CLAIM A REFUND OF INCOME TAXES, PAY ADDITIONAL INCOME TAXES, OR
DESIGNATE A DOLLAR TO A PRESIDENTIAL ELECTION CAMPAIGN FUND. THE
INFORMATION IS NEEDED TO HELP VERIFY THAT THE INDIVIDUAL HAS
CORRECTLY FIGURED HIS OR HER INCOME TAX.
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.