Information Collection

Employers

IC 196433 under ICR 201102-0970-002 · OMB 0970-0154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Employers	Form and Instruction
Attachment B - Income Withholding for Support Instructions.doc	Instruction
1 Record Layout Attachment E--e-IWO Record Layout.doc	Form and Instruction
1 Withholding for Support Attachment A - Income Withholding for Support, OMB 0970-0154.doc	Form
Attachment D - Applicable Statutes.pdf Applicable Statutes	IC Document

IC Title:

Employers

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Record Layout	Attachment E--e-IWO Record Layout.doc	Yes	Yes	Fillable Fileable
Form	1	Withholding for Support	Attachment A - Income Withholding for Support, OMB 0970-0154.doc	Yes	Yes	Fillable Fileable
Instruction			Attachment B - Income Withholding for Support Instructions.doc	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,232,622

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,860,976	9,860,976
Annual IC Time Burden (Hours)	328,699	328,699
Annual IC Cost Burden (Dollars)	15,272,087	15,272,087

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Applicable Statutes	Attachment D - Applicable Statutes.pdf	02/24/2011

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