Information Collection

Form 941SS -V -(Preprinted)

IC 187193 under ICR 200910-1545-022 · OMB 1545-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 941-SS-V Form 941SS -V -(Preprinted)	Form and Instruction
941-SS-V Payment Voucher Form 941SS-V Preprinted.pdf	Form and Instruction
brdn_busi 941SS-V preprinted.PDF Burden for 941SS-V	IC Document

IC Title:

Form 941SS -V -(Preprinted)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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 and Instruction	941-SS-V	Payment Voucher	Form 941SS-V Preprinted.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,798,054

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	2,400	2,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden for 941SS-V	brdn_busi 941SS-V preprinted.PDF	11/12/2008

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