Information Collection

Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution

IC 43878 under ICR 202205-1545-008 · OMB 1545-1502.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1502 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5304 SIMPLE Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution	Form
5304 SIMPLE Savings Incentive Match Plan for Employees of Small Empl 2012 5304SIMPLE.pdf	Form
5304 SIMPLE Savings Incentive Match Plan for Employees of Small Empl 2012 5304SIMPLE.pdf	Form
2016-5304-SIMPLE brdn_busi.PDF Burden -Form 5304-SIMPLE	IC Document
2016-5304-SIMPLE brdn_busi.PDF Burden -Form 5304-SIMPLE	IC Document

IC Title:

Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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	5304 SIMPLE	Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)ÂNot for Use With a Designated Financial Institution	2012 5304SIMPLE.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100,000

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	100,000	100,000
Annual IC Time Burden (Hours)	640,000	640,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden -Form 5304-SIMPLE	2016-5304-SIMPLE brdn_busi.PDF	01/07/2016

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