Information Collection

Form 12114 - Continuation Sheet for Item # 15 (Additional Information) OF-306, Declaration for Federal Employment

IC 19623 under ICR 201711-1545-003 · OMB 1545-1921.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1921 can be found here:

Documents and Forms

Document Name Document Type
Form 12114 Form 12114 - Continuation Sheet for Item # 15 (Additional Information) OF-306, Declaration for Federal Employment Form
12114 Continuation Sheet (Additional Information) for OF-306, Form 12114--2017-04-00.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 12114 - Continuation Sheet for Item # 15 (Additional Information) OF-306, Declaration for Federal Employment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	12114	Continuation Sheet (Additional Information) for OF-306, Declaration for Federal Employment	Form 12114--2017-04-00.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title: IRS 24.030--Customer Account Data Engine Individual Master File; IRS 34.037--IRS Audit Trail and Security Records System	FR Citation: 80 FR 54064

Number of Respondents: 24,813	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	24,813	24,813
Annual IC Time Burden (Hours)	6,203	6,203
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.