Small Business Office Order Blank

ICR 200411-1545-036

OMB: 1545-1638

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
41001 Migrated
ICR Details
1545-1638 200411-1545-036
Historical Active 200311-1545-054
TREAS/IRS
Small Business Office Order Blank
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/30/2004
Retrieve Notice of Action (NOA) 11/30/2004
  Inventory as of this Action Requested Previously Approved
05/31/2005 05/31/2005 05/31/2005
500 0 5,000
42 0 417
0 0 0

Form 12196 is to be used by small business outlets to order IRS tax forms and publications. The form can be faxed directly to the IRS Area Distribution Center for order fulfillment, packaging and mailing.

None
None


No

1
IC Title Form No. Form Name
Small Business Office Order Blank FORM-12196

  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 5,000 0 -4,500 0 0
Annual Time Burden (Hours) 42 417 0 -375 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.
11/30/2004


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