Information Collection

Intake/Interview and Quality Review Sheet

IC 19697 under ICR 202503-1545-012 · OMB 1545-1964.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13614-C Intake/Interview and Quality Review Sheet	Form
Form 13614-C Intake/Interview & Quality Review Sheet Intake/Interview and Quality Review Sheet	Form
13614-C Intake/Interview & Quality Review Sheet f13614-c--2025-03-00--web.pdf	Form
13614-C Intake/Interview & Quality Review Sheet f13614-c--2025-03-00--web.pdf	Form

IC Title:

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				Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,561,781

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	Previously Approved
Annual Number of Responses for this IC	2,561,781	2,561,781
Annual IC Time Burden (Hours)	426,964	426,964
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].