Short Form Return of Organization Exempt From Income Tax

Forms and Documents

Document Name	Status
Form Schedule N Form 99 Sch N Liquidation, Termination, Dissolution or Significant Disposition of Assets Form and Instruction	Modified
Form Schedule L Form 99 Sch L_Transactions with Interested Persons Form	Modified
Form Schedule G Form 99 Sch G_Supplemental Information Regarding Fundraising or Gaming Activities Form	Modified
Form Schedule E Form 99 Sch E_Schools Form	Modified
Form Schedule C Form 99 Sch C_Political Campaign and Lobbying Activities Form	Modified
Form Schedule B Form 99 Sch B_Schedule of Contributors Form and Instruction	Modified
Form Schedule A Form 99 Sch A_Public Charity Status and Public Form	Modified
Form 990-EZ Short Form Return of Organization Exempt From Income Tax Form	Modified
Sup Stmnt Form 990-EZ.doc Supporting Statement A	2011-12-13

IC Document Collections

IC ID	Document Title	Status
186599	Sch N Liquidation, Termination, Dissolution or Significant Disposition of Assets Form and Instruction	Modified
186594	Sch L_Transactions with Interested Persons Form	Modified
186589	Sch G_Supplemental Information Regarding Fundraising or Gaming Activities Form	Modified
186586	Sch E_Schools Form	Modified
186584	Sch C_Political Campaign and Lobbying Activities Form	Modified
186579	Sch B_Schedule of Contributors Form and Instruction	Modified
186552	Sch A_Public Charity Status and Public Form	Modified
17893	Short Form Return of Organization Exempt From Income Tax Form	Modified

ICR Details

OMB Control No: 1545-1150	ICR Reference No: 201112-1545-019
Status: Historical Active	Previous ICR Reference No: 200809-1545-009
Agency/Subagency: TREAS/IRS	Agency Tracking No: jg-1150-019
Title: Short Form Return of Organization Exempt From Income Tax
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/2011
	Date Received in OIRA: 12/28/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved	12/31/2011
Responses	890,187	0	890,187
Time Burden (Hours)	43,656,636	0	43,656,636
Cost Burden (Dollars)	0	0	0

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Abstract: Form 990-EZ is needed to determine that IRS section 501(a) tax- exempt organizations fulfill the operating conditions within the limitations of their tax exemption. IRS uses the information from this form to determine if the filers are operating within the rules of their exemption.

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Authorizing Statute(s): US Code: 26 USC 6033 Name of Law: Returns by exempt organizations
   US Code: 26 USC 501 Name of Law: Exemption from tax on corporations, certain trusts, etc.
   US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 53168	08/25/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 81557	12/28/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Short Form Return of Organization Exempt From Income Tax	990-EZ	Short Form Return of Organization Exempt From Income Tax
Sch A_Public Charity Status and Public	Schedule A Form 990-EZ	Public Charity Status and Public Support
Sch L_Transactions with Interested Persons	Schedule L Form 990-EZ	Transactions With Interested Persons
Sch C_Political Campaign and Lobbying Activities	Schedule C Form 990-EZ	Political Campaign and Lobbying Activities
Sch G_Supplemental Information Regarding Fundraising or Gaming Activities	Schedule G Form 990-EZ	Supplemental Information Regarding Fundraising or Gaming Activities
Sch N Liquidation, Termination, Dissolution or Significant Disposition of Assets	Schedule N Form 990-EZ	Liquidation, Termination, Dissolution, or Significant Disposition of Assets
Sch B_Schedule of Contributors	Schedule B Form 990-EZ	Schedule of Contributors
Sch E_Schools	Schedule E Form 990-EZ	Schools

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	890,187	890,187	0	0	0	0
Annual Time Burden (Hours)	43,656,636	43,656,636	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $734,165

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/28/2011

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