Information Collection

Form 8453-WH

IC 257380 under ICR 202509-1545-008 · OMB 1545-0967.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8453-WH Form 8453-WH	Form and Instruction
Form 8453-WH E-file Declaration for Form 1042 Form 8453-WH	Form and Instruction
8453-WH E-file Declaration for Form 1042 f8453-wh--2022-12-00.pdf	Form and Instruction
8453-WH E-file Declaration for Form 1042 f8453-wh--2022-12-00.pdf	Form and Instruction

IC Title:

Form 8453-WH

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.6012-5

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	8453-WH				Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title: Treasury/IRS 22.062; Treasury/IRS 24.046; Treasury/IRS 34.037

FR Citation: 80 FR 54064

Number of Respondents: 40,067

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40,067	-11,383	51,450
Annual IC Time Burden (Hours)	87,346	-24,815	112,161
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.

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