View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1545-2235
ICR Reference No:
201209-1545-002
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
TREAS/IRS
Agency Tracking No:
1545-XXXX-XXX
Title:
Form 14417 - Reimbursable Agreement-Non-Federal Entities
Type of Information Collection:
Existing collection in use without an OMB Control Number
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
09/11/2012
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/12/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/04/2012
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2013
6 Months From Approved
Responses
300
0
0
Time Burden (Hours)
150
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
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.
Emergency Justfication:
This form is used to collect customer information to develop reimbursable agreements with non-federal entities. It was recently flagged as requiring an OMB control number. Throughout this 4th quarter, Fiscal Year 2013 non-federal agreements are developed for our customers. IRS finance offices across the nation are waiting for this form to be approved. IRS has scheduled the training of service-wide finance offices on the use of this form during the week September 10, 2012. We would like to have an approved form for immediate use during and after the training.
Authorizing Statute(s):
US Code:
26 USC 6103(p)
Name of Law: Procedure and recordkeeping
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Form 14417--Reimbursable Agreement - Non-Federal Entities
Form 14417
Reimbursable Agreement--Non-Federal Entities
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
300
0
0
0
0
300
Annual Time Burden (Hours)
150
0
0
0
0
150
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$80,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Angela McElmurray 202 622-6193
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/04/2012
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