Form 14039 - Identity Theft Affidavit

Identity Theft Affidavit

OMB: 1545-2139

IC ID: 188032

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Form 14039 - Identity Theft Affidavit
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

General Government Taxation Management

 

100,000 0
   
Individuals or Households
 
   0 %

  Approved 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 80,000 0 0 0 0 80,000
Annual IC Time Burden (Hours) 20,000 0 0 0 0 20,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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