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Statement of Payments Received
Statement of Payments Received
OMB: 1545-0364
IC ID: 129772
OMB.report
TREAS/IRS
OMB 1545-0364
ICR 202305-1545-025
IC 129772
( )
Documents and Forms
Document Name
Document Type
Form 4669
Statement of Payments Received
Form and Instruction
4669 Statement of Payments Received
Form_4669[1].pdf
Form and Instruction
4669 Statement of Payments Received
Form_4669[1].pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Statement of Payments Received
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4669
Statement of Payments Received
Form_4669[1].pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
IRS 24.046 BMF, and Treas/IRS 34.047 audit trail and security records
FR Citation:
83 FR 42980
Number of Respondents:
85,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
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
85,000
0
0
0
0
85,000
Annual IC Time Burden (Hours)
21,250
0
0
0
0
21,250
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.