Form 14417 - Reimbursable Agreement - Non-Federal Entities; Form 14417-A - Statistics of Income - User Fee

OMB 1545-2235

Information collected with this form will be used by the IRS to enter into cost reimbursable agreements with state, local, foreign government, and commercial entities. The authority to perform services on a cost reimbursable basis is contained in Section 6103(p) of the Internal Revenue Code. Performance of services is authorized when consistent with the basic public obligations of the IRS.

The latest form for Form 14417 - Reimbursable Agreement - Non-Federal Entities; Form 14417-A - Statistics of Income - User Fee expires 2023-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 14417-A Form 14417-A - Statistics of Income - User Fee Form
Form Form 14417 Form 14417--Reimbursable Agreement - Non-Federal Entities Form and Instruction
SUP STAT (1545-2235)-Final.docx Supporting Statement A
Form 14417-A - Statistics of Income - User Fee Form
Form 14417--Reimbursable Agreement - Non-Federal Entities Form and Instruction

All Historical Document Collections

202211-1545-013 Approved without change	Extension without change of a currently approved collection	2023-01-31
201908-1545-027 Approved without change	Extension without change of a currently approved collection	2019-12-30
201607-1545-029 Approved without change	Extension without change of a currently approved collection	2016-07-29
201303-1545-026 Approved without change	Revision of a currently approved collection	2013-03-28
201209-1545-002 Approved without change	Existing collection in use without an OMB Control Number	2012-09-04

OMB Details

Form 14417--Reimbursable Agreement - Non-Federal Entities

Federal Enterprise Architecture: General Government - Taxation Management

Form Form 14417

Reimbursable Agreement--Non-Federal Entities

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Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.