View Information Collection (IC)

View Information Collection (IC)

IC Title:	Form 941-X - Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	941-X	Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund	Form_941-X_REV_APR2013.pdf		Yes	Yes	Fillable Fileable
Instruction			INST_Form_941-X_APR2013.pdf		Yes	No	Printable Only
Other-DRAFT_Form_941-X_APR2014			DRAFT_Form_941-X_APR2014.pdf		Yes	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,798,054	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	100,000	0	0	0	0	100,000
Annual IC Time Burden (Hours)	1,754,000	0	0	0	0	1,754,000
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Burden for 941-X	Form 941-X brdn_busi.PDF	11/19/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.