Information Collection

Election to be Treated as an Interest Charge DISC

IC 17086 under ICR 201208-1545-026 · OMB 1545-0190.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4876-A Election to be Treated as an Interest Charge DISC	Form and Instruction
4876-A Election to be treated as an Interest Charge DISC Form and Instruction 4876-A.pdf	Form and Instruction
2012 Burden Form 4876-A.PDF 2012 Burden Form 8876-A	IC Document

IC Title:

Agency IC Tracking Number:

jg-0190-026

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	4876-A	Election to be treated as an Interest Charge DISC	Form and Instruction 4876-A.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	6,360	6,360
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2012 Burden Form 8876-A	2012 Burden Form 4876-A.PDF	08/17/2012

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