Information Collection

Revenue Procedure 2017-15, Qualified Intermediary Agreement

IC 18868 under ICR 202105-1545-015 · OMB 1545-1597.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1597 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 14345 Revenue Procedure 2017-15, Qualified Intermediary Agreement	Form and Instruction
14345 Application for Qualified Intermediary, Withholding f14345--2016-10-00.pdf	Form and Instruction
14345 Application for Qualified Intermediary, Withholding f14345--2016-10-00.pdf	Form and Instruction
Rev Proc 2014-39.pdf Revenue Procedure 2014-39	IC Document
Rev Proc 2014-39.pdf Revenue Procedure 2014-39	IC Document
Rev Proc 2000-12.pdf Revenue Procedure 2000-12	IC Document
Rev Proc 2000-12.pdf Revenue Procedure 2000-12	IC Document
Rev Proc 2003-64.pdf Revenue Procedure 2003-64	IC Document
Rev Proc 2003-64.pdf Revenue Procedure 2003-64	IC Document
Rev Proc 2014-47.pdf Revenue Procedure 2014-47	IC Document
Rev Proc 2014-47.pdf Revenue Procedure 2014-47	IC Document
Rev Proc 2004-21.pdf Revenue Procedure 2004-21	IC Document
Rev Proc 2004-21.pdf Revenue Procedure 2004-21	IC Document
Rev Proc 2005-77.pdf Revenue Procedure 2005-77	IC Document
Rev Proc 2005-77.pdf Revenue Procedure 2005-77	IC Document
Rev Proc 2017-15.pdf Revenue Procedure 2017-15	IC Document
Rev Proc 2017-15.pdf Revenue Procedure 2017-15	IC Document

IC Title:

Revenue Procedure 2017-15, Qualified Intermediary Agreement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 1.441-1

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	14345	Application for Qualified Intermediary, Withholding	f14345--2016-10-00.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: IRS 24.046 Customer Account Data Engine Business Master File and Treas/IRS 34.047 Audit trail and security records system

FR Citation: 80 FR 54064

Number of Respondents: 88,504

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,097,991	1,097,991
Annual IC Time Burden (Hours)	301,018	301,018
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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