Information Collection

Form 8275 - Disclosure Statement

IC 39853 under ICR 201609-1545-017 · OMB 1545-0889.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0889 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8275 Form 8275 - Disclosure Statement	Form
i8275--2013-08-00.pdf	Instruction
8275 Disclosure Statement f8275--2013-08-00.pdf www.irs.gov/form8275	Form
2012 8275 burden.PDF 2012 Burden	IC Document

IC Title:

Form 8275 - Disclosure Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.6661 26 CFR 1.6662

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	8275	Disclosure Statement	f8275--2013-08-00.pdf	www.irs.gov/form8275	Yes	Yes	Fillable Fileable
Instruction			i8275--2013-08-00.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 666,666

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 1 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	333,333	333,333
Annual IC Time Burden (Hours)	1,893,332	1,893,332
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2012 Burden	2012 8275 burden.PDF	07/17/2013

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