U.S. Departing Alien Income Tax Return

ICR 200109-1545-009

OMB: 1545-0086

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
16877 Migrated
ICR Details
1545-0086 200109-1545-009
Historical Active 199809-1545-027
TREAS/IRS
U.S. Departing Alien Income Tax Return
Extension without change of a currently approved collection   No
Regular
Approved without change 11/02/2001
Retrieve Notice of Action (NOA) 09/04/2001
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
11/30/2004 11/30/2004 11/30/2001
2,500 0 2,500
11,292 0 11,312
0 0 0

Form 1040-C is used by aliens departing the U.S. to report income received or expected to be received for the entire tax year. The data collected are used to insure that the departing alien has no outstanding U.S. tax liability.

None
None


No

1
IC Title Form No. Form Name
U.S. Departing Alien Income Tax Return 1040-C

  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 2,500 2,500 0 0 0 0
Annual Time Burden (Hours) 11,292 11,312 0 -20 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
09/04/2001


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