FORM 4752 - QUESTIONNAIRE, HEAD OF
HOUSEHOLD - WAS DEVELOPED TO ASSIST IN DETERMINING WHETHER OR NOT
AN INDIVIDUAL MAY BE ELIGIBLE TO USE THIS FILING STATUS AND ITS'
MORE FAVORABLE TAX RATE. THIS ADDITIONAL INFORMATION MAY BE
REQUESTED BASED ON DATA ON THE TAX RETURN OR ON DATA SUBMITTED IN
CONNECTION WITH AN EXAMINATION OF THE RETURN.
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.