Certification Regarding Tax Matters; FAR Section Affected 52.209-12

Prohibition on Contracting with Corporations with Delinquent Taxes or a Felony Conviction. FAR Sections Affected: 52.209-11 & 52.209-12; FAR Case 2015-011;

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 9000-0193 can be found here:

Documents and Forms

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no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Certification Regarding Tax Matters; FAR Section Affected 52.209-12	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 48 CFR 52.209-12

Information Collection Instruments:

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

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 440	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,320	0	1,320
Annual IC Time Burden (Hours)	132	0	132
Annual IC Cost Burden (Dollars)	5,544	5,544	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.