EMPLOYMENT - REFERENCE INQUIRY

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
129614	EMPLOYMENT - REFERENCE INQUIRY Form	Migrated

ICR Details

OMB Control No: 1545-0274	ICR Reference No: 198111-1545-004
Status: Historical Inactive	Previous ICR Reference No: 198108-1545-024
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: EMPLOYMENT - REFERENCE INQUIRY
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Disapproved and continue	Conclusion Date: 11/17/1981
	Date Received in OIRA: 11/11/1981
Terms of Clearance: This request for continued use of form 2163 beyond January 31, 1982 is not approved. In submitting the request the Department did not indicate the consequences of not receiving these data which duplicate information already provided by the applicant. If these data are used in a meaningful way, so as to have practical utility, the Department should be able to indicate how many forms 2163 are received each year, on the average, how many indicate that the applicant may have misstate a fact sufficiently important as to raise question about their suitability for employment, and how many of these situations result in terminations of employment. If the Department should wish to again request approval for continued use of this form, it must provide data demonstrating practical utility and, therefore, the need to obtain information from references duplicating that already provided by the applicants.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/1982	01/31/1982	01/31/1982
Responses	20,000	0	20,000
Time Burden (Hours)	4,000	0	4,000
Cost Burden (Dollars)	0	0	0

---

Abstract: THIS FORM IS USED TO VERIFY PAST EMPLOYMENT HISTORY AND TO QUESTION LISTED AND DEVELOPED REFERENCES AS TO THE CHARACTER AND INTEGRITY OF CURRENT OR POTENTIAL IRS EMPLOYEES. THE INFORMATION RECEIVED IS INCORPORATED INTO A REPORT ON WHICH A SECURITY DETERMINATION IS BASED.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

---

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
EMPLOYMENT - REFERENCE INQUIRY	2163

---

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: $0

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

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: 11/11/1981

---