Information Collection

Form 13930-A

IC 236098 under ICR 201905-1545-011 · OMB 1545-2102.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2102 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13930-A Form 13930-A	Form and Instruction
13930-A Application for Central Withholding Agreement Less than f13930-A_2019 revision.pdf	Form and Instruction

IC Title:

Form 13930-A

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.1441-4(b)(3)

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	13930-A	Application for Central Withholding Agreement Less than $10,000	f13930-A_2019 revision.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: IRS 24.030 Individual Master File

FR Citation: 83 FR 42980

Number of Respondents: 1,000

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	10,500	10,500
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.