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Revised Form W4 Usability
Collection of Qualitative Feedback on Agency Service Delivery
OMB: 1545-2256
IC ID: 234528
OMB.report
TREAS/IRS
OMB 1545-2256
ICR 201704-1545-039
IC 234528
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2256 can be found here:
2023-08-30 - Extension without change of a currently approved collection
2020-06-29 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
W-4 Usability Test Protocol.docx
Other-survey
W-4 Usability Testing Screening phone.docx
Other-Survey
Intro Letter for W4 Usability Testing.docx
Other-Letter
Consent Form.docx
Other-Letter
W-4 Usability Scenarios and Vignettes.docx
Other-survey
MITRE Invitation Letter.docx
Other-Letter
W4 Usability Testing Research Plan.docx
Other-Survey
RevisedForm W4 Usability - Short Form.docx
Short Form
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Revised Form W4 Usability
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-survey
W-4 Usability Test Protocol.docx
No
Paper Only
Other-Survey
W-4 Usability Testing Screening phone.docx
No
Paper Only
Other-Letter
Intro Letter for W4 Usability Testing.docx
No
Paper Only
Other-Letter
Consent Form.docx
No
Paper Only
Other-survey
W-4 Usability Scenarios and Vignettes.docx
No
Paper Only
Other-Letter
MITRE Invitation Letter.docx
No
Paper Only
Other-Survey
W4 Usability Testing Research Plan.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,200
0
1,200
0
0
0
Annual IC Time Burden (Hours)
166
0
166
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Short Form
RevisedForm W4 Usability - Short Form.docx
12/17/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.