Social Security and Medicare Tax on Unreported Tip Income

ICR 200007-1545-003

OMB: 1545-0059

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
1545-0059 200007-1545-003
Historical Active 199707-1545-033
TREAS/IRS
Social Security and Medicare Tax on Unreported Tip Income
Extension without change of a currently approved collection   No
Regular
Approved without change 08/31/2000
Retrieve Notice of Action (NOA) 07/05/2000
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
08/31/2003 08/31/2003 09/30/2000
76,000 0 76,000
101,080 0 90,440
0 0 0

Section 3102 requires an employee who receives tips subject to Social Security and Medicare tax to compute tax due on these tips if the employee did not report them to his or her employer. The data is used to help verify that the Social Security and Medicare tax on tip income is correctly computed.

None
None


No

1
IC Title Form No. Form Name
Social Security and Medicare Tax on Unreported Tip Income FORM-4137

  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 76,000 76,000 0 0 0 0
Annual Time Burden (Hours) 101,080 90,440 0 10,640 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
07/05/2000


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