Supplemental Attachment to Schedule M-3

Forms and Documents

Document Name	Status
Form Form 8916-A Supplemental Attachment to Schedule M-3 Form and Instruction	Modified
Non-Display Expiration Date Statement.docx Supplementary Document	2010-10-29
F8916-A_Sup Stmnt.rtf Supporting Statement A	2010-09-13

IC Document Collections

IC ID	Document Title	Status
46167	Supplemental Attachment to Schedule M-3 Form and Instruction	Modified

ICR Details

OMB Control No: 1545-2061	ICR Reference No: 201009-1545-019
Status: Historical Active	Previous ICR Reference No: 200705-1545-066
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Supplemental Attachment to Schedule M-3
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/06/2011
	Date Received in OIRA: 10/29/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2014	36 Months From Approved	01/31/2011
Responses	156,000	0	156,000
Time Burden (Hours)	5,049,720	0	5,049,720
Cost Burden (Dollars)	0	0	0

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Abstract: The Form 8916-A is a detailed schedule that reconciles the amount of the cost of goods sold, interest income and interest expense reported on Schedule M-3 for the Form 1065, Form 1120, 1120-S, 1120-L, or 1120-PC.

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Authorizing Statute(s): US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
   PL: Pub.L. 105 - 206 Title II, Sections 2001 - 2005 Name of Law: Electronic Filing
   US Code: 26 USC 6011 Name of Law: General requirement of return, statement, or list
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 38176	07/01/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 65708	10/26/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Supplemental Attachment to Schedule M-3	8916-A, Form 8916-A	Supplemental Attachment to Schedule M-3 ,   2010 Draft Form 8916-A

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	156,000	156,000	0	0	0	0
Annual Time Burden (Hours)	5,049,720	5,049,720	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/29/2010

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