Information Collection

Consumer Cooperative Exemption Application

IC 19659 under ICR 201112-1545-021 · OMB 1545-1941.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1941 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3491 Consumer Cooperative Exemption Application	Form and Instruction
3491 Consumer Cooperative Exemption Application Form 3491 and Instructions.pdf	Form and Instruction

IC Title:

Consumer Cooperative Exemption Application

Agency IC Tracking Number:

jg-1941-021

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.6044-4

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3491	Consumer Cooperative Exemption Application	Form 3491 and Instructions.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	148	148
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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