Form 14039-SP - Declaración Jurada sobre el Robo de Identidad

Identity Theft Affidavit

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2139 can be found here:

Documents and Forms

Document Name Document Type
Form 14039 Form 14039-SP - Declaración Jurada sobre el Robo de Identidad Form and Instruction
14039 Declaraci?n Jurada sobre el Robo de Identidad Form 14039(SP) and Instructions.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Form 14039-SP - Declaración Jurada sobre el Robo de Identidad	Agency IC Tracking Number:	ah-2139-012

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 and Instruction	14039	Declaraci?n Jurada sobre el Robo de Identidad	Form 14039(SP) 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: 100,000	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	20,000	20,000
Annual IC Time Burden (Hours)	5,000	5,000
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.