FORM 5434, Application for Enrollment; and Form 5434-A, Application for Renewal of Enrollment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0951 can be found here:

Documents and Forms

Document Name Document Type
Form Form 5434 FORM 5434, Application for Enrollment; and Form 5434-A, Application for Renewal of Enrollment Form and Instruction
Form 5434 Application for Enrollment Form 5434.pdf Form and Instruction
Form 5434-A Application for Renewal of Enrollment Form 5434-A.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FORM 5434, Application for Enrollment; and Form 5434-A, Application for Renewal of Enrollment	Agency IC Tracking Number:	db-0951-022

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 901

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 5434	Application for Enrollment	Form 5434.pdf		Yes	No	Fillable Printable
Form and Instruction	Form 5434-A	Application for Renewal of Enrollment	Form 5434-A.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,000	6,000
Annual IC Time Burden (Hours)	3,800	3,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.