Statement for Claiming Benefits Provided by Section 911 of the Internal Revenue Code

ICR 199701-1545-002

OMB: 1545-0666

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1545-0666 199701-1545-002
Historical Active 199401-1545-003
TREAS/IRS
Statement for Claiming Benefits Provided by Section 911 of the Internal Revenue Code
Extension without change of a currently approved collection   No
Regular
Approved without change 02/19/1997
Retrieve Notice of Action (NOA) 01/09/1997
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
03/31/2000 03/31/2000 02/28/1997
50,000 0 50,000
25,000 0 25,000
0 0 0

Form 673 is completed by a citizen of the United States and is furnished to his or her employer in order to exclude from income tax withholding all or part of the wages paid the citizen for services performed outside the United States.

None
None


No

1
IC Title Form No. Form Name
Statement for Claiming Benefits Provided by Section 911 of the Internal Revenue Code 673

  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 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 25,000 25,000 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.
01/09/1997


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