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Agreement to Mediate
Agreement to Mediate
OMB: 1545-1844
IC ID: 19490
OMB.report
TREAS/IRS
OMB 1545-1844
ICR 201211-1545-048
IC 19490
( )
Documents and Forms
Document Name
Document Type
Form 13369
Agreement to Mediate
Form
13369 Agreement to Mediate
Form 13369.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Agreement to Mediate
Agency IC Tracking Number:
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
13369
Agreement to Mediate
Form 13369.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
Agreement to Mediate
FR Citation:
71 FR 29392
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
300
0
0
0
0
300
Annual IC Time Burden (Hours)
15
0
0
0
0
15
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
