SuppStatement Form 12311

SuppStatement Form 12311.doc

Notice Regarding Repayment of a Buyout Prior to Re-employment with the Federal Government

OMB: 1545-1920

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SUPPORTING STATEMENT

Form 12311


  1. CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION


This form requests applicants to certify if they ever worked for the Federal Government and if they received a Buyout within the last 5 years. This is to ensure that applicants who meet the criteria are counseled that they are required to pay back the entire Buyout prior to entering on duty with the IRS.


Public Law (PL) 103-226 & PL 104-208; 5 CFR 550.710 and 550.771


  1. USE OF DATA


Information on this form will be used to determine if an applicant was previously employed by the Federal Government, and if they received a Buyout within the last 5 years so they can be counseled by Personnel.


  1. USE OF IMPROVED INFORMATION TECHNOLOGY TO REDUCE BURDEN


We have no plans at this time to offer electronic filing because of low volume compared to the cost of electronic enabling.


  1. EFFORTS TO IDENTIFY DUPLICATION


We have attempted to eliminate duplication within the agency wherever possible.


  1. METHODS TO MINIMIZE BURDEN ON SMALL BUSINESS OR OTHER SMALL ENTITIES


Not applicable


  1. CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR POLICY ACTIVITIES


Not applicable


  1. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT WITH GUIDELINES IN 5 CFR 1320.5(D) (2)


Not applicable


  1. 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 12311.


In response to the Federal Register notice dated June 6, 2011, (76 FR 32407), we received no comments during the comment period regarding Form 12311.


  1. EXPLANATION OF DECISION TO PROVIDE ANY PAYMENT OR GIFT TO RESPONDENTS


Not applicable.


  1. ASSURANCE OF CONFIDENTIALITY OF RESPONSES


Information submitted by applicants is confidential as required by 5 USC 552a


  1. JUSTIFICATION OF SENSITIVE QUESTIONS


Not applicable


  1. ESTIMATED BURDEN OF INFORMATION COLLECTION


Number of Time per Total

Responses Response Hours


Form 12311 33,085 5 minutes 2,757


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


  1. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS


As suggested by OMB, our Federal Register notice dated June 6, 2011, (76 FR 32407), requested public comments on estimates 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 receive any response from taxpayers on this subject. As a result, estimates of the cost burdens are not available at this time.



  1. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT


The primary cost to the government consists of the cost of printing. Printing of Form12854 is done as part of an application booklet at a cost of $2,950.00 per 1,000.


  1. REASONS FOR CHANGE IN BURDEN


There is no change in the paperwork burden previously approved by OMB.


This form is being submitted for renewal purposes only.


  1. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION


Not Applicable


  1. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE


See attachment


  1. EXCEPTIONS TO THE CERTIFICATION STATEMENT ON OMB FORM 83I


Not Applicable


Note: The following paragraph applies to all of the collections of information in this submission.


An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the collection of information displays a valid OMB control number. Books or records relating to a collection of information must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential as required by 26 U.S.C. 6103.


File Typeapplication/msword
File TitleSupporting Statement – Form 12885; Supplement to OF-612, Optional Application for Federal Employment
Authorljmccar6
Last Modified ByJNMNB
File Modified2011-10-15
File Created2004-12-21

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