Information Collection

Form 15434

IC 263935 under ICR 202312-1545-015 · OMB 1545-2316.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2316 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 15434 Form 15434	Form and Instruction
15434 Application for Employee Retention Credit (ERC) Voluntar Form 15434 (12-2023).pdf	Form and Instruction

IC Title:

Form 15434

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	15434	Application for Employee Retention Credit (ERC) Voluntary Disclosure Program	Form 15434 (12-2023).pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

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
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	11,800	11,800
Annual IC Cost Burden (Dollars)	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.