Tip Rate Determination Agreement (for use by employers in the food and beverage industry)

ICR 200403-1545-012

OMB: 1545-1715

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
1545-1715 200403-1545-012
Historical Active 200103-1545-011
TREAS/IRS
Tip Rate Determination Agreement (for use by employers in the food and beverage industry)
Extension without change of a currently approved collection   No
Regular
Approved without change 04/20/2004
Retrieve Notice of Action (NOA) 03/17/2004
  Inventory as of this Action Requested Previously Approved
04/30/2007 04/30/2007 05/31/2004
200 0 200
1,737 0 1,737
0 0 0

Information is required by the Internal Revenue Service in its tax compliance efforts to assist employers and their employees in understanding and complying with section 6053(a), which requires employees to report all their tips monthy to their employers.

None
None


No

1
IC Title Form No. Form Name
Tip Rate Determination Agreement (for use by employers in the food and beverage industry)

  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 200 200 0 0 0 0
Annual Time Burden (Hours) 1,737 1,737 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
03/17/2004


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