F14029 ..

PAPERWORK REDUCTION ACT SUBMISSION
Please read the Instructions before completing this form.
2. Agency : Department of Treasury, Internal Revenue Service

1. Type of IC Review:
New Form (Attach Supporting Statement)
Revision to Previously Approved IC (Attach IRS - OMB
Review Request Form)
Extension to previously approved IC (3-yr)
Reinstatement of previously approved IC
Existing IC in use that does not contain an OMB
control number
Deletion of currently approved IC

3. OMB Control No:

1 5 4 5 –

4. Type of Review:
Regular
Emergency * – Date Requested
By:
/
/
5. Small Entities: Will this ICR have a significant economic
impact on a substantial number of small entities?
Yes
No
7. Emergency Justification: Technical Authorization(TA):
(provide reference source)

6. Requested Expiration Date:
Three years from approval date
Other - Specify:

Not applicable

8. Emergency Justification Statement:
Not applicable

IC INFORMATION
9. Title:

Request for Miscellaneous Determination Under Sections 507, 509(a), 4940, 4942, 4945, and 6033 of the IRC

10. Agency form number(s) (if applicable):

Form 8940

11. Authorizing Statute(s) for this IC:
US Code: Title
Public Law:
Statute at Large:
EO:

26

USC: Sec.
Public Law:
Statute:
EO:

501(c)

Name of Law: Exempt
Section:
Name of Law:
Name/Subject of EO:

Organizations (Also Code sections in Form title.)
Name of Law:

12. Abstract:

Form 8940 will standardize information collection procedures for 9 categories of individually written requests for miscellaneous determinations now
submitted to the Service by requestor letter. Respondents are exempt organizations.

13. Affected Public: (Mark primary with “P” and all others that
apply with “X”)
Individuals or households
Business or other for-profit
P Not-for-profit institutions

Farms
Federal Government
State, Local, or Tribal Gov’t

14. Annual Reporting and Recordkeeping burden hours:
a. Number of respondents . . . . . . . . .
b. Total annual responses . . . . . . . . .
1. Percentage of these responses
collected electronically . . . . . . . .
c.
d.
e.
f.

Total annual hours requested .
Current OMB inventory. . . . . .
Difference . . . . . . . . . . . . . .
Explanation of difference
1. Program change . . . . . . . .
2. Adjustment . . . . . . . . . . . .

2,100
2,100
0

....
.... 0
....
.... X
....

14a. Verification of estimated filers: (Provide source of
estimated filers)

Exempt Organizations Determination Office. See the
response to Question 12 of the Supporting Statement for
additional details.
15. Statistical Method: Does the ICR contain surveys,
censuses, or employ statistical methods?
Yes

No

Form 14029 (Rev. 4-2009)

16. Obligation to respond: (Mark primary with “P” and all
others that apply with “X”)
Voluntary

Mandatory

P Required to obtain or retain benefits

17. CFR citations: (Provide source(s) of change)
CFR
CFR
CFR

A.
B.
C.

18. Purpose of IC: (Mark primary with “P” and all others that
apply with “X”)
P Application for benefits
Program evaluation
General Purpose statistics
Audit

Program planning or management
Research
Regulatory or compliance

19. Frequency of Recordkeeping or Reporting: (check all
that apply)
Recordkeeping
Reporting:
On occasion
Quarterly
Biennially

Third party disclosure
Weekly
Semi-annually
Other (describe)

Monthly
Annually

Initial determination

20. Agency Contact:
Name:
Phone:

Catalog Number 51944B

Department of the Treasury–Internal Revenue Service

SUPPORTING STATEMENT
1. CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION
The proposed collection of information is necessary for the proper performance of the Service in granting
miscellaneous determinations under sections 507, 509(a), 4940, 4942, 4945 and 6033 of the IRC.

2. USE OF DATA
The data will be used by the Exempt Organizations Determinations Office at the Service to evaluate requests for
miscellaneous determinations.

3. USE OF IMPROVED INFORMATION TECHNOLOGY TO REDUCE BURDEN
Information technology was considered to reduce burden. We have no plans to offer electronic filing at this time
because of the low volume compared to the cost cost of electronic enabling.

4. EFFORTS TO IDENTIFY DUPLICATION
This is a request for an initial miscellaneous determination. Any similar information already available cannot be used or
modified for the purpose described in item 2 above. We have attemptd to eliminate duplication within the Service
wherever possible.

5. METHODS TO MINIMIZE BURDEN ON SMALL BUSINESSES OR OTHER SMALL ENTITIES
Not applicable (No significant impact on a substantial number of small businesses or other small entities)

6. CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR
POLICY ACTIVITIES
Not applicable (No consequences to Federal program or policy activities)

Form 14029 (Rev. 4-2009) Catalog Number 51944B Page 4

Department of the Treasury–Internal Revenue Service

7. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT
WITH GUIDELINES IN 5 CFR 1320.5(d)(2)
Not applicable (No special circumstances)

8. CONSULTATION WITH INDIVIDUALS OUTSIDE OF THE AGENCY ON AVAILABILITY
OF DATA, FREQUENCY OF COLLECTION, CLARITY OF INSTRUCTIONS AND FORMS,
AND DATA ELEMENTS
Periodic meetings are held between IRS personnel and representatives of the American Bar Association, the National
Society of Public Accountants, the American Institute of Certified Public Accountants, and other professional groups to
discuss tax law and tax forms. During these meetings, there is an opportunity for those attending to make comments
regarding Form 8940.
In response to the Federal Register notice dated February 15, 2011 (76 FR 8845), we recieved no comments during
the comment period regarding Form 8940.

9. EXPLANATION OF DECISION TO PROVIDE ANY PAYMENT OR GIFT TO RESPONDENTS
Not applicable (No payment or gift will be provided)

10. ASSURANCE OF CONFIDENTIALITY OF RESPONSES
Generally, tax returns and tax return information are confidential. However, under Public Disclosure Requirements,
Exempt Organizations must make available for public inspection certain annual returns and applications for exemption,
and must provide copies of such returns and appications to individuals who request them.

11. JUSTIFICATION OF SENSITIVE QUESTIONS
Not applicable (No sensitive questions)

12. ESTIMATED BURDEN OF INFORMATION COLLECTION
Number of
Responses
2100

Time per
Response
13.79

Total
Hours
28,959

Estimates of the annualized cost to repondents for the hour burdens shown are not available at this time.

Form 14029 (Rev. 4-2009) Catalog Number 51944B

Page 5

Department of the Treasury–Internal Revenue Service

13. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS
As suggested by OMB, our Federal Register notice dated February 15, 2011 (76 FR 8845), requested pubic comments
on estimates of of cost burden that are not captured in the estimates of burden hours, i.e., estimates of capital or
start-up costs and costs of operation, maintenance, and purchase of services to provide information. However, we did
not recieve any response from taxpayers on this subject. As a result, estimtes of the cost burdens are not available at
this time.

14. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT
The primary cost to the Service is the cost of printing Form 8940 which is nominal.

15. REASONS FOR CHANGE IN BURDEN
Not applicable (This is a new collection)

16. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION
Not applicable (Individual entity results will not be published)

17. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE
See attachment.

18. EXCEPTIONS TO THE CERTIFICATION STATEMENT ON OMB PRA SUBMISSION FORM
Not applicable (No exceptions)

19. REASON FOR EMERGENCY SUBMISSION

Form 14029 (Rev. 4-2009) Catalog Number 51944B

Page 6

Department of the Treasury–Internal Revenue Service