Request for Discharge From Personal Liability Under Internal Revenue Code Section 2204 or 6905

Form 5495 - Request for Discharge From Personal Liability Under Internal Revenue Code Section 2204 or 6905

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0432 can be found here:

Documents and Forms

Document Name Document Type
Form 5495 Request for Discharge From Personal Liability Under Internal Revenue Code Section 2204 or 6905 Form and Instruction
5495 Request for Discharge From Personal Liability Under Inte Form_5495_DEC2008.pdf Form and Instruction
2018-5495-2018-09-27 09-32-36 (burden).pdf 2018 Burden IC Document

Information Collection (IC) Details

IC Title:	Request for Discharge From Personal Liability Under Internal Revenue Code Section 2204 or 6905	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 301.6905-1 26 CFR 20.2204-1,2 26 CFR 20.6905-1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5495	Request for Discharge From Personal Liability Under Internal Revenue Code Section 2204 or 6905	Form_5495_DEC2008.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title: IRS.34.037	FR Citation: 80 FR 54063

Number of Respondents: 1,800	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	25,000	25,000
Annual IC Time Burden (Hours)	306,500	306,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2018 Burden	2018-5495-2018-09-27 09-32-36 (burden).pdf	09/27/2018

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