Information Collection

Form 14417-A - Statistics of Income - User Fee

IC 206240 under ICR 202511-1545-017 · OMB 1545-2235.

Documents and Forms

Document Name Document Type
Form 14417-A Statistics of Income - User Fee Form 14417-A - Statistics of Income - User Fee Form
14417-A Statistics of Income - User Fee Form 14417-A (Rev. 3-2023).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 14417-A - Statistics of Income - User Fee	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	14417-A	Statistics of Income - User Fee	Form 14417-A (Rev. 3-2023).pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5	-5	10
Annual IC Time Burden (Hours)	5	-5	10
Annual IC Cost Burden (Dollars)	0	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.

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