Information Collection

Income Verification Express Service Application and Employee Delegation Form

IC 44344 under ICR 200607-1545-044 · OMB 1545-2032.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2032 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13803 Income Verification Express Service Application and Employee Delegation Form	Form
13803 Income Verification Express Service Form 13803 ( second draft).pdf	Form
RevProc Draft 6-13-06.doc Rev. Proc.	IC Document

IC Title:

Income Verification Express Service Application and Employee Delegation Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 301.6103(c)-1

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	13803	Income Verification Express Service	Form 13803 ( second draft).pdf		Yes	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Rev. Proc.	RevProc Draft 6-13-06.doc	07/26/2006

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