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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.