Income Verification Express Service Application and Employee Delegation Form

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.