Information Collection

Geographic Availability Statement

IC 17605 under ICR 200906-1545-024 · OMB 1545-0973.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0973 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 8569 Geographic Availability Statement	Form
Form 8569 Geographic Availability Statement Form 8569.pdf	Form

IC Title:

Geographic Availability Statement

Agency IC Tracking Number:

db-0973-024

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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	Form 8569	Geographic Availability Statement	Form 8569.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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)	84	84
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.