Information Referral

ICR 201205-1545-012

OMB: 1545-1960

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2009-03-10
Supporting Statement A
2012-05-15
IC Document Collections
IC ID
Document
Title
Status
19689 Modified
ICR Details
1545-1960 201205-1545-012
Historical Active 200903-1545-016
TREAS/IRS ah-1960-016
Information Referral
Extension without change of a currently approved collection   No
Regular
Approved without change 08/06/2012
Retrieve Notice of Action (NOA) 05/29/2012
  Inventory as of this Action Requested Previously Approved
08/31/2015 36 Months From Approved 08/31/2012
215,000 0 215,000
53,750 0 53,750
0 0 0

This application is voluntary and the information requested helps us determine if there has been a violation of Income Tax Law. We need the taxpayer identification numbers-Social Security Number (SSN) or Employer Identification Number (EIN) in order to fully process your application. Failure to provide this information may lead to suspension of processing this application.

US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of other documents.
  
None

Not associated with rulemaking

  77 FR 16589 03/21/2012
77 FR 31433 05/25/2012
No

1
IC Title Form No. Form Name
Information Referral 3949-A Information Referral

  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 215,000 215,000 0 0 0 0
Annual Time Burden (Hours) 53,750 53,750 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$4,000
No
No
No
No
No
Uncollected
Gary Johnson 9723081804

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/29/2012


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