Information Collection

Form 8453-R - Declaration and Signature for Electronic Filing of Forms 8947 and 8963

IC 210086 under ICR 201702-1545-012 · OMB 1545-2253.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2253 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8453-R Form 8453-R - Declaration and Signature for Electronic Filing of Forms 8947 and 8963	Form and Instruction
8453-R Declaration and Signature for Electronic Filing of Forms Form 8453-R (12-2016).pdf	Form and Instruction
brdn_busi.pdf Burden	IC Document
TD_9544.docx TD 9544	IC Document
TD_9643 (Final).docx TD 9643	IC Document
TD_9643 (Correction).rtf TD 9643 (Correction)	IC Document

IC Title:

Form 8453-R - Declaration and Signature for Electronic Filing of Forms 8947 and 8963

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR Part 51 26 CFR 51.8T 26 CFR Part 57 (To search for a specific CFR, visit the Code of Federal Regulations.)

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 and Instruction	8453-R	Declaration and Signature for Electronic Filing of Forms 8947 and 8963	Form 8453-R (12-2016).pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,550	2,550
Annual IC Time Burden (Hours)	4,131	4,131
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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