Information Collection

Form 13775 - Tax Check Waiver

IC 194648 under ICR 201009-1545-048 · OMB 1545-1791.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1791 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13775 Form 13775 - Tax Check Waiver	Form
13775 TaxCheck Waiver 48048i10_r16_java.pdf	Form

IC Title:

Form 13775 - Tax Check Waiver

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	13775	TaxCheck Waiver	48048i10_r16_java.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 65

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	75	75
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.