Request for Federal Income Tax Withholding From Sick Pay

ICR 200009-1545-017

OMB: 1545-0717

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
1545-0717 200009-1545-017
Historical Active 199708-1545-009
TREAS/IRS
Request for Federal Income Tax Withholding From Sick Pay
Extension without change of a currently approved collection   No
Regular
Approved without change 11/29/2000
Retrieve Notice of Action (NOA) 09/20/2000
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
11/30/2003 11/30/2003 11/30/2000
500,000 0 500,000
765,000 0 690,000
0 0 0

Section 3402(o) of the Internal Revenue Code extends income tax withholding to sick pay payment made by third parties upon request of the payee. The information is used to determine the amount to be withheld from the third-party sick pay payment.

None
None


No

1
IC Title Form No. Form Name
Request for Federal Income Tax Withholding From Sick Pay FORM-W-4S

  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 500,000 500,000 0 0 0 0
Annual Time Burden (Hours) 765,000 690,000 0 75,000 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.
09/20/2000


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