Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations

Forms and Documents

Document Name	Status
Form 990-W Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations Form	Modified
990-W Supporting Statement.doc Supporting Statement A	2012-12-20

IC Document Collections

IC ID	Document Title	Status
190895	Form 990W Schedule A (Part III) Other-null	Modified
190894	Form 990-W Schedule A (Part II) Other-null	Modified
190893	Form 990W Schedule A (Part I) Other-null	Modified
17611	Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations Form	Modified

ICR Details

OMB Control No: 1545-0976	ICR Reference No: 201211-1545-007
Status: Historical Active	Previous ICR Reference No: 200910-1545-002
Agency/Subagency: TREAS/IRS	Agency Tracking No: ah-0976-007
Title: Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/25/2013
	Date Received in OIRA: 12/28/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2016	36 Months From Approved	02/28/2013
Responses	19,151	0	19,151
Time Burden (Hours)	220,310	0	220,310
Cost Burden (Dollars)	0	0	0

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Abstract: Form 990-W is used by tax-exempt trusts and tax-exempt corporations to figure estimated tax liability on unrelated business income and on investment income for private foundations and the amount of each installment payment. Form 990-W is a worksheet only. It is not required to be filed.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 64187	10/18/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 76604	12/28/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Form 990-W Schedule A (Part II)
Form 990W Schedule A (Part III)
Form 990W Schedule A (Part I)
Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations	990-W	Estimated Tax on Unrelated Business Taxable Income for Tax-Exempt Organizations

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ICR Summary 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	19,151	19,151	0	0	0	0
Annual Time Burden (Hours)	220,310	220,310	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,631

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/28/2012

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