The agency may
omit the expiration date on the form.
Inventory as of this Action
Requested
Previously Approved
08/31/1999
08/31/1999
11/30/1996
100
0
100
137
0
135
0
0
0
Used by bona fide residents of
American Samoa whose income is from sources within American Samoa,
Guam, and the Northern Mariana Islands to the extent specified in
IRC section 931. This information is used by the Service to
determine if an individual is eligible to exclude possession source
income.
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.