Allocation of Individual Income Tx to Guam or the Commonwealth of the Northern Mariana Islands (CNMI)

ICR 200210-1545-044

OMB: 1545-0803

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1545-0803 200210-1545-044
Historical Active 200109-1545-025
TREAS/IRS
Allocation of Individual Income Tx to Guam or the Commonwealth of the Northern Mariana Islands (CNMI)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 10/03/2002
Retrieve Notice of Action (NOA) 10/03/2002
  Inventory as of this Action Requested Previously Approved
11/30/2004 11/30/2004 11/30/2004
50 0 50
212 0 209
0 0 0

Form 5074 is used by U.S. citizens or residents as an attachment to Form 1040 when they have $50,000 or more in adjusted gross income from U.S. sources and $5,000 or more in gross income from Guam or the Commonwealth of the Northern Mariana Islands (CNMI). The data is used by IRS to allocate income tax due to Guam or CNMI as required by 26 U.S.C. 7654.

None
None


No

1
IC Title Form No. Form Name
Allocation of Individual Income Tx to Guam or the Commonwealth of the Northern Mariana Islands (CNMI) 5074

  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 50 0 0 0 0
Annual Time Burden (Hours) 212 209 0 3 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.
10/03/2002


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