Information Collection

QTAX F-72 Redesign Cognitive Testing

IC 237927 under ICR 201812-0607-001 · OMB 0607-0978.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0978 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 QTAX F-72 Redesign Cognitive Testing	Form and Instruction
1 Revised F-72 Instrument F72_Revised 8.14.19.xlsx	Form and Instruction
2 Original F-72 Instrument Original blank F72.xlsx	Form and Instruction
QTax OMB generic clearance letter draft 28Oct2019.docx OMB Memo	IC Document
Draft QTAX protocol 8.14.19.docx Protocol	IC Document
New F-72 tax code descriptions for classification manual 8.14.19.docx F-72 Classification Manual	IC Document

IC Title:

QTAX F-72 Redesign Cognitive Testing

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	1	Revised F-72 Instrument	F72_Revised 8.14.19.xlsx		No		Fillable Fileable
Form and Instruction	2	Original F-72 Instrument	Original blank F72.xlsx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	QTax OMB generic clearance letter draft 28Oct2019.docx	10/28/2019
Protocol	Draft QTAX protocol 8.14.19.docx	09/30/2019
F-72 Classification Manual	New F-72 tax code descriptions for classification manual 8.14.19.docx	09/30/2019

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