Information Collection

Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act

IC 266171 under ICR 202403-1545-014 · OMB 1545-2324.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 15293 Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act	Form and Instruction
Form 15293 Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act	Form and Instruction
15293 Consent for Disclosure of Non-Tax IRS Records Protected f15293--2024-04-00--r5.pdf	Form and Instruction
15293 Consent for Disclosure of Non-Tax IRS Records Protected f15293--2024-04-00--r5.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	15293				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: IRS 24.030--Customer Account Data Engine Individual Master File, formerly Individual Master File, and IRS 34.037--IRS Audit Trail and Security Records System

FR Citation: 80 FR 54064

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	75	75
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.

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