View Information Collection (IC)

View Information Collection (IC)

IC Title:	Form 941SS -V -(Preprinted)	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 and Instruction	941 SS / V	Employer’s QUARTERLY Federal Tax Return SS	2017_f941ss.pdf		Yes	Yes	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: 50 %

	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	10,000	0	0	0	0	10,000
Annual IC Time Burden (Hours)	2,400	0	0	0	0	2,400
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Burden_2017_941_SS_V_PP	Burden_2017-941_SS_V_PP.pdf	06/09/2017

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