Information Collection

Tax Check Waiver

IC 41119 under ICR 200810-1545-007 · OMB 1545-1791.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1791 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 12339-A Tax Check Waiver	Form
12339-A Tax Check Waiver Form 12339-A.pdf	Form
12339 Internal Revenue Service Advisory Council Membership App Form 12339.pdf	Form
12339-B Information Reporting Program Advisory Committee Members Form 12339-B.pdf	Form

IC Title:

Tax Check Waiver

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	12339-A	Tax Check Waiver	Form 12339-A.pdf	Yes	No	Fillable Printable
Form	12339	Internal Revenue Service Advisory Council Membership Application	Form 12339.pdf	Yes	No	Fillable Printable
Form	12339-B	Information Reporting Program Advisory Committee Membership Application	Form 12339-B.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	417	417
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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