Geographic Availability Statement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0973 can be found here:

Documents and Forms

Document Name Document Type
Form 8569 Geographic Availability Statement Form
8569 Geographic Availability Statement Form 8569.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Geographic Availability Statement	Agency IC Tracking Number:	jg-0973-028

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	8569	Geographic Availability Statement	Form 8569.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.