FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions

Financial Institution Data Match / Federally Assisted State Transmitted Levy

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0196 can be found here:

Documents and Forms

Document Name Document Type
Form 1 FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions Form
1 FAST Levy Record Specs 0970-0196 FAST_Levy_Record Specifications.docx Form

Information Collection (IC) Details

IC Title:	FAST Levy Response Withhold Record Specifications: Multistate Financial Institutions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 45 CFR 303.7

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	FAST Levy Record Specs	0970-0196 FAST_Levy_Record Specifications.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	1,588	1,588
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.