Employment Tax Adjustments and Rules Relating to Additional Medicare Tax

Forms and Documents

Document Name	Status
2019_1545-2097.doc Supporting Statement A	2019-12-06

IC Document Collections

IC ID	Document Title	Status
222638	TD 9645, Rules relating to additional Medicare tax: Large and small entities	Unchanged
199155	TD 9645, Rules relating to additional Medicare tax: Individuals and all other respondents Other-T D 9645 Final	Unchanged
182807	Employment Tax Adjustments Other-TD 9405 Final	Unchanged

ICR Details

OMB Control No: 1545-2097	ICR Reference No: 201911-1545-019
Status: Active	Previous ICR Reference No: 201607-1545-006
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Employment Tax Adjustments and Rules Relating to Additional Medicare Tax
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/12/2020
	Date Received in OIRA: 12/27/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved	02/29/2020
Responses	3,400,000	0	3,400,000
Time Burden (Hours)	16,900,000	0	16,900,000
Cost Burden (Dollars)	0	0	0

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Abstract: This information is required to verify compliance with return requirements under section 6011, employment tax adjustments under section 6205 and 6413, and claims for refund of overpayments of employment taxes under section 6402 and 6414.

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Authorizing Statute(s): US Code: 26 USC 6413(a) Name of Law: Special rules applicable to certain employment taxes
   US Code: 26 USC 6205(a) Name of Law: Special rules applicable to certain employment taxes
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 37009	07/30/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 71531	12/27/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Employment Tax Adjustments
TD 9645, Rules relating to additional Medicare tax: Individuals and all other respondents
TD 9645, Rules relating to additional Medicare tax: Large and small entities

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,400,000	3,400,000	0	0	0	0
Annual Time Burden (Hours)	16,900,000	16,900,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/27/2019

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