OMB control number
Form 14417 - Reimbursable Agreement - Non-Federal Entities; Form 14417-A - Statistics of Income - User Fee
OMB 1545-2235 · TREAS/IRS.
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 2026-07-31 and is listed under ICR 202211-1545-013.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 14417-A Statistics of Income - User Fee | Form |
| Form Form 14417 Reimbursable Agreement--Non-Federal Entities | Form and Instruction |
 1545-2235 Supporting Statement 2026.docx | Supporting Statement A |
| p1075--2021-11-00.pdf | Supplementary Document |
 Form 14417-A - Statistics of Income - User Fee |
Form |
| Form 14417--Reimbursable Agreement - Non-Federal Entities |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202511-1545-017 | Extension without change of a currently approved collection | 2026-04-30 | ||
| 202211-1545-013 | Extension without change of a currently approved collection | 2023-01-31 | Approved without change | |
| 201908-1545-027 | Extension without change of a currently approved collection | 2019-12-30 | Approved without change | |
| 201607-1545-029 | Extension without change of a currently approved collection | 2016-07-29 | Approved without change | |
| 201303-1545-026 | Revision of a currently approved collection | 2013-03-28 | Approved without change | |
| 201209-1545-002 | Existing collection in use without an OMB Control Number | 2012-09-04 | Approved without change |
OMB Details
Form 14417--Reimbursable Agreement - Non-Federal Entities
Federal Enterprise Architecture: General Government - Taxation Management
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form Form 14417 | Reimbursable Agreement--Non-Federal Entities | Fillable Printable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.