Information Collection

Intake/Interview and Quality Review Sheet

IC 19697 under ICR 202209-1545-008 · OMB 1545-1964.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1964 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13614-C Intake/Interview and Quality Review Sheet	Form
13614-C Intake/Interview & Quality Review Sheet f13614-c--2021-10-00.pdf	Form
13614-C Intake/Interview & Quality Review Sheet f13614-c--2021-10-00.pdf	Form

IC Title:

Intake/Interview and Quality Review Sheet

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	13614-C	Intake/Interview & Quality Review Sheet	f13614-c--2021-10-00.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,700,000

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	Previously Approved
Annual Number of Responses for this IC	3,700,000	370,000	3,330,000
Annual IC Time Burden (Hours)	616,667	61,667	555,000
Annual IC Cost Burden (Dollars)	0	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.