View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1545-0064	ICR Reference No: 200902-1545-001
Status: Historical Active	Previous ICR Reference No: 200604-1545-014
Agency/Subagency: TREAS/IRS	Agency Tracking No: CB-0064-001
Title: Application for Exemption From Social Security and Medicare Taxes and Waiver of Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/22/2009
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/03/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2012	36 Months From Approved	05/31/2009
Responses	3,754	0	3,754
Time Burden (Hours)	3,792	0	3,154
Cost Burden (Dollars)	0	0	0

Authorizing Statute(s): US Code: 26 USC 1402 Name of Law: TAX ON SELF-EMPLOYMENT INCOME
   US Code: 26 USC 3127 Name of Law: Exemption for employers and their employees where both are members of religious faiths opposed to pa
   US Code: 26 USC 3111 Name of Law: Rate of tax
   US Code: 26 USC 3101 Name of Law: Rate of tax
   US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information

Citations for New Statutory Requirements: US Code: 26 USC 3127(c)(2) Name of Law: Exemption for employers and their employees where both are members of religious faiths opposed to pa
US Code: 26 USC 1402(g)(2) Name of Law: TAX ON SELF-EMPLOYMENT INCOME

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion
Annual Number of Responses	3,754	3,754	0	0
Annual Time Burden (Hours)	3,792	3,154	478	160
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Form revised due to addresses for filing applications for exemption and revoking exemptions were updated. Revision of form, added 3 code references, 2 line items and 1,161 words. See "Summary of Changes" in the Supplementary Documents section. Burden hours increased to 3,792.