Information Collection

Intake/Interview and Quality Review Sheet (English & 9 Translations)

IC 19697 under ICR 201701-1545-009 · OMB 1545-1964.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1964 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13614-C Intake/Interview & Quality Review Sheet Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (AR) Intake/Interview & Quality Review Sheet - Arabic Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (CN Simpli Intake/Interview & Quality Review Sheet - Chinese (Simplified) Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (CN Tradit Intake/Interview & Quality Review Sheet - Chinese Traditional Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (TL) Intake/Interview & Quality Review Sheet - Tagalog Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (VN) Intake/Interview & Quality Review Sheet - Vietnamese Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (PL) Intake/Interview & Quality Review Sheet - Polish Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (PT) Intake/Interview & Quality Review Sheet - (Portuguese) Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (KR) Intake/Interview & Quality Review Sheet - Korean Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
Form 13614-C (HT) Intake/Interview & Quality Review Sheet - Creole French Intake/Interview and Quality Review Sheet (English & 9 Translations)	Form
13614-C Intake/Interview & Quality Review Sheet f13614-c--2016-10-00.pdf	Form
13614-C (AR) Intake/Interview & Quality Review Sheet - Arabic f13614-c_ar--2016-10-00.pdf	Form
13614-C (CN Simpli Intake/Interview & Quality Review Sheet - Chinese (Simpl f13614-c_cn-s--2016-10-00.pdf	Form
13614-C (CN Tradit Intake/Interview & Quality Review Sheet - Chinese Tradit f13614-c_cn-t--2016-10-00.pdf	Form
13614-C (TL) Intake/Interview & Quality Review Sheet - Tagalog f13614-c_tl--2016-10-00.pdf	Form
13614-C (VN) Intake/Interview & Quality Review Sheet - Vietnamese f13614-c_vn--2016-10-00.pdf	Form
13614-C (PL) Intake/Interview & Quality Review Sheet - Polish f13614-c_pl--2016-10-00.pdf	Form
13614-C (PT) Intake/Interview & Quality Review Sheet - (Portuguese) f13614-c_pt--2016-10-00.pdf	Form
13614-C (KR) Intake/Interview & Quality Review Sheet - Korean f13614-c_kr--2016-10-00.pdf	Form
13614-C (HT) Intake/Interview & Quality Review Sheet - Creole French f13614-c_ht--2016-10-00.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Intake/Interview and Quality Review Sheet (English & 9 Translations)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	13614-C	Yes	No	Fillable Printable
Form	13614-C (AR)	Yes	No	Fillable Printable
Form	13614-C (CN Simplified)	Yes	No	Fillable Printable
Form	13614-C (CN Traditional)	Yes	No	Fillable Printable
Form	13614-C (TL)	Yes	No	Fillable Printable
Form	13614-C (VN)	Yes	No	Fillable Printable
Form	13614-C (PL)	Yes	No	Fillable Printable
Form	13614-C (PT)	Yes	No	Fillable Printable
Form	13614-C (KR)	Yes	No	Fillable Printable
Form	13614-C (HT)	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,330,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,330,000	3,330,000
Annual IC Time Burden (Hours)	555,000	555,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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