Information Collection

Social Security and Medicare Tax on Unreported Tip Income

IC 16830 under ICR 200309-1545-003 · OMB 1545-0059.

Documents and Forms

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Document Name	Document Type

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IC Title:

Social Security and Medicare Tax on Unreported Tip Income

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4137				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 76,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 56 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	76,000	76,000
Annual IC Time Burden (Hours)	101,080	101,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.