CONSENT OF SHAREHOLDER TO INCLUDE SPECIFIC AMOUNT OF GROSS INCOME

ICR 199501-1545-004

OMB: 1545-0043

Federal Form Document

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ICR Details
1545-0043 199501-1545-004
Historical Active 199202-1545-013
TREAS/IRS
CONSENT OF SHAREHOLDER TO INCLUDE SPECIFIC AMOUNT OF GROSS INCOME
Extension without change of a currently approved collection   No
Regular
Approved without change 03/16/1995
Retrieve Notice of Action (NOA) 01/10/1995
You may omit printing the expiration date on this form.
  Inventory as of this Action Requested Previously Approved
03/31/1998 03/31/1998 05/31/1995
1 0 0
408 0 408
0 0 0

FORM 972 IS FILED BY SHAREHOLDERS OF CORPORATIONS TO ELECT TO INCLUDE AN AMOUNT IN GROSS INCOME AS A DIVIDEND. THE IRS USES FORM 972 AS A CHECK TO SEE IF AN AMENDED RETURN IS FILED TO INCLUDE THE AMOUNT IN INCOME AND TO DETERMINE IF THE CORPORATION CLAIMED THE CORRECT AMOUNT.

None
None


No

1
IC Title Form No. Form Name
CONSENT OF SHAREHOLDER TO INCLUDE SPECIFIC AMOUNT OF GROSS INCOME 972

  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 1 0 0 1 0 0
Annual Time Burden (Hours) 408 408 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.
01/10/1995


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