Dividend Equivalents from Sources within the United States (REG-120282-10 & 127895-14) & Forms 1042, 1042-S and 1042-T

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1042 Annual Withholding Tax Return for U.S. Source Income of Foreign Persons	Form	Modified	Available
Form 1042-T (draft ty 2 Annual Summary and Transmittal of Forms 1042-S	Form and Instruction	Modified	Available
Form 1042-T Annual Summary and Transmittal of Forms 1042-S	Form and Instruction	Modified	Available
Form 1042-S Foreign Person's U.S. Source Income Subject to Withholding	Form	Modified	Available
REG–120282–10 2nd NPRM.pdf	Supplementary Document	Uploaded 2015-08-21	Available
REG–157714–06.pdf	Supplementary Document	Uploaded 2015-08-21	Available
Summary of Comments to 2012 NPRM.docx	Supplementary Document	Uploaded 2015-08-20	Available
OMB Expiration.docx	Supplementary Document	Uploaded 2015-08-20	Available
Supporting Statement 1545-0096 rev 8-19.doc	Supporting Statement A	Uploaded 2015-08-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
39506	Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons	Form	Modified	Annual Withholding Tax Return for U.S. Source Income of Foreign Persons
39506	Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons	Instruction	Modified
217930	REG-120282-10 (Final) / Dividend Equivalents from Sources within the United States		New
185426	Annual Summary and Transmittal of Forms 1042-S	Form and Instruction	Modified	Annual Summary and Transmittal of Forms 1042-S
185426	Annual Summary and Transmittal of Forms 1042-S	Form and Instruction	Modified	Annual Summary and Transmittal of Forms 1042-S
185425	Foreign Person's U.S. Source Income Subject to Withholding	Form	Modified	Foreign Person's U.S. Source Income Subject to Withholding
185425	Foreign Person's U.S. Source Income Subject to Withholding	Instruction	Modified

ICR Details

OMB Control No: 1545-0096	ICR Reference No: 201601-1545-002
Status: Historical Active	Previous ICR Reference No: 201411-1545-013
Agency/Subagency: TREAS/IRS	Agency Tracking No: ready
Title: Dividend Equivalents from Sources within the United States (REG-120282-10 & 127895-14) & Forms 1042, 1042-S and 1042-T
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/05/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/05/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	6 Months From Approved	03/31/2018
Responses	3,611,200	0	3,581,200
Time Burden (Hours)	2,945,594	0	2,705,594
Cost Burden (Dollars)	0	0	0

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Abstract: The regulations pertain to section 871(m) regarding dividend equivalent payments that are treated as U.S. source income. These regulations provide guidance regarding when payments made pursuant to certain financial instruments will be treated as U.S. -source income and subject to U.S. withholding tax. The information provided is necessary to permit withholding agents to determine whether U.S. withholding tax is due with respect to a payment of a dividend equivalent and the amount of the tax. The information will also be used for audit and examination purposes. Form 1042 is used by withholding agents to report tax withheld at source on certain income paid to nonresident alien individuals, foreign partnerships, and foreign corporations to the IRS. Form 1042-S is used by withholding agents to report income and tax withheld to payees. A copy of each 1042-S is filed magnetically or with Form 1042 for information reporting purposes. The IRS uses this information to verify that the correct amount of tax has been withheld and paid to the United States. Form 1042-T is used by withholding agents to transmit Forms 1042-S to the IRS.

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Authorizing Statute(s): US Code: 26 USC 6001 Name of Law: Notice or regulations requiring records, statement, and special returns
   US Code: 26 USC 1461 Name of Law: Liability for withheld tax
   US Code: 26 USC 871 Name of Law: Tax on nonresident alien individuals
   US Code: 26 USC 1441 Name of Law: Withholding of tax on nonresident aliens
   US Code: 26 USC 1442 Name of Law: Withholding of tax on foreign corporations
   US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1545-BJ56	Final or interim final rulemaking	80 FR 56886	09/08/2015

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Annual Summary and Transmittal of Forms 1042-S	1042-T, 1042-T (draft ty 2015)	Annual Summary and Transmittal of Forms 1042-S ,   Annual Summary and Transmittal of Forms 1042-S
Foreign Person's U.S. Source Income Subject to Withholding	1042-S	Foreign Person's U.S. Source Income Subject to Withholding
Form 1042, Annual Withholding Tax Return for U.S. Source Income of Foreign Persons	1042	Annual Withholding Tax Return for U.S. Source Income of Foreign Persons
REG-120282-10 (Final) / Dividend Equivalents from Sources within the United States

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ICR Summary of Burden

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	3,611,200	3,581,200	0	30,000	0	0
Annual Time Burden (Hours)	2,945,594	2,705,594	0	240,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: By adding the REG-120282-10 to this information collection request, it has increased the annual time burden by 240,000 hours. The agency estimates that 30,000 respondents will prepare the statements as required by section 1.871-15(p) . It estimated that it will take 8 minutes to complete the statement.

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Annual Cost to Federal Government: $180,153

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: 08/21/2015

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