Form 15434

Employee Retention Credit Voluntary Disclosure Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2316 can be found here:

Documents and Forms

Document Name Document Type
Form 15434 Form 15434 Form and Instruction
15434 Application for Employee Retention Credit (ERC) Voluntar Form 15434 (12-2023).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Form 15434	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	15434	Application for Employee Retention Credit (ERC) Voluntary Disclosure Program	Form 15434 (12-2023).pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	11,800	11,800
Annual IC Cost Burden (Dollars)	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.