Information Collection Request

Form 14420 - Verification of Reported Income

ICR 201209-1545-007 · OMB 1545-2236 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 14420 Form 14420 - Verification of Reported Income Form New Available
ombat1.doc Supplementary Document Uploaded 2012-09-14 Available
Supporting Statement.pdf Supporting Statement A Uploaded 2012-10-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
204043 Form 14420 - Verification of Reported Income Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2013 6 Months From Approved
5,600 0 0
22,400 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Form 14420 - Verification of Reported Income 14420 Verification of Reported Income

table that charts list 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 5,600 0 0 5,600 0 0
Annual Time Burden (Hours) 22,400 0 0 22,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No