IRC 6103(C) AND REGULATIONS THEREUNDER
REQUIRE THAT TAX INFORMATION CAN ONLY BE GIVEN TO A DESIGNEE OF
TAXPAYER IF A PROPER CONSENT IS GRANTED. THIS FORM IS USED TO
ASSIST MEMBERS OF CONGRESS IN ASSURING THAT THEY HAVE PROPER
CONSENT BEFORE THEY SEEK ASSISTANCE FROM THE IRS ON BEHALF OF THEIR
CONSTITUENTS. DATA IS USED TO IDENTIFY THE TAX INFORMATION
AUTHORIZED TO BE DISCLOSED.
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:
(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;
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.