Consent of Shareholder to Include Specific Amount in Gross Income

Forms and Documents

Document Name	Status
Form 972 Consent of Shareholder to Include Specific Amount in Gross Income Form	Modified
Supporting statement[0043].doc Supporting Statement A	0000-00-00
1545-0043.pdf Supplementary Document	2006-03-09

IC Document Collections

IC ID	Document Title	Status
39400	Consent of Shareholder to Include Specific Amount in Gross Income Form	Modified

ICR Details

OMB Control No: 1545-0043	ICR Reference No: 200701-1545-033
Status: Historical Active	Previous ICR Reference No: 200603-1545-046
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Consent of Shareholder to Include Specific Amount in Gross Income
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2007
	Date Received in OIRA: 02/12/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2010	36 Months From Approved	05/31/2007
Responses	100	0	267
Time Burden (Hours)	385	0	380
Cost Burden (Dollars)	0	0	0

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Abstract: Form 972 is filed by shareholders of corporations to elect to include an amount in gross income as a divided. The IRS uses Form 972 as a check to see if an amended return is filed to include the amount in income and to determine if the corporation claimed the correct amount.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 58471	10/03/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 6666	02/12/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Consent of Shareholder to Include Specific Amount in Gross Income	972	Consent of Shareholder to Include Specific Amount in Gross Income

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ICR Summary of Burden

	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	100	267	0	-167	0	0
Annual Time Burden (Hours)	385	380	0	5	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Changes were made to correct numbers to be consistent with Change Worksheet filed March 9, 2006. These changes result in a decrease of 167 responses and an increase of 5 hours. A copy of prior submission is attached to this ICR.

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Annual Cost to Federal Government: $130

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/12/2007

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