Race and National Origin Identification

ICR 199907-1545-005

OMB: 1545-1398

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
18247 Migrated
ICR Details
1545-1398 199907-1545-005
Historical Active 199608-1545-007
TREAS/IRS
Race and National Origin Identification
Extension without change of a currently approved collection   No
Regular
Approved without change 09/10/1999
Retrieve Notice of Action (NOA) 07/16/1999
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
09/30/2002 09/30/2002 09/30/1999
50,000 0 50,000
2,500 0 2,500
0 0 0

Form 9620 is an optically scannable form that is used to collect race and national origin data on all IRS employees and new hires. The form is a valuable tool in allowing the IRS to meet its diversity/EEO goals and as a component of its referral and tracking system and recruitment program.

None
None


No

1
IC Title Form No. Form Name
Race and National Origin Identification FORM-9620

  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) 2,500 2,500 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.
07/16/1999


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