Information Collection Request

Liability of Third Parties Paying or Providing for Wages

ICR 201312-1545-015 · OMB 1545-2254 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 4219 Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes Form and Instruction New Available
Attachement to OMB Supporting Statement..doc Supplementary Document Uploaded 2013-12-13 Available
Supporting_Statement(4219).pdf Supporting Statement A Uploaded 2014-02-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
209679 Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2014 6 Months From Approved
1,000 0 0
12,833 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes 4219 Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes

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 1,000 0 0 0 0 1,000
Annual Time Burden (Hours) 12,833 0 0 0 0 12,833
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No