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 and IRS Request for Individual Access to Non-Tax Records under the Privacy Act

Documents and Forms

Document Name Document Type
Form 15293 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

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	15293	Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act	f15293--2024-04-00--r5.pdf		Yes	Yes	Fillable Fileable

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 %

	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

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.