Summary of changes

IRS - OMB REVIEW REQUEST FORM
Request for OMB review of currently approved document:
Date:

03/08/2010

Name:
Office Symbols:
Phone Number:

Summary of Changes
Form 13441-EZ is a simplified version of Form 13441 and will be used for a streamlined batch process to register
groups of individuals for the monthly HCTC Program.

Impact on Approved Collection
Public
Law No.

Regulation
No.

Other
Code
References

SAMPLE:
PL 109-567

REG-345675-08

RP 2009-134

+/- 5

Change In IRS Form
& Instructions
No. of Filers
Words

+/- 20,000

+/- 500

Attachments

+/- 1

*Please insert how this new (PL, REG, or other), document will affect the currently approved collection.

IRS - OMB REVIEW REQUEST FORM
Request for OMB review of currently approved document:
Date:

Name:

03/08/2010

Office Symbols:
Phone Number:

Additional Information:

2

(Continued)