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Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
Form 4219, Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
OMB: 1545-2254
IC ID: 209679
OMB.report
TREAS/IRS
OMB 1545-2254
ICR 202103-1545-003
IC 209679
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2254 can be found here:
2024-07-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 4219
Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
Form and Instruction
4219 Statement of Liability of Lender, Surety, or Other Perso
2014 Form 4219 and instructions.pdf
Form and Instruction
4219 Statement of Liability of Lender, Surety, or Other Perso
2014 Form 4219 and instructions.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
26 CFR 31.3505-1
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4219
Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
2014 Form 4219 and instructions.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
IRS 24.046-Customer Account Data Engine Business Master File
FR Citation:
80 FR 54064
Number of Respondents:
1,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Farms, Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,000
0
0
0
0
1,000
Annual IC Time Burden (Hours)
12,833
0
0
0
0
12,833
Annual IC Cost Burden (Dollars)
0
0
0
0
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.