Information Collection

Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution

IC 43878 under ICR 201212-1545-006 · OMB 1545-1502.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1502 can be found here:

Documents and Forms

Document Name Document Type
Form 5304 SIMPLE Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution Form
5304 SIMPLE Savings Incentive Match Plan for Employees of Small Empl 2012 5304SIMPLE.pdf Form
2012 5304SIMPLE burden.PDF 2012 Form 5304-SIMPLE Burden IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 5304-SIMPLE Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)-Not for Use With a Designated Financial Institution	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	5304 SIMPLE	Savings Incentive Match Plan for Employees of Small Employers (SIMPLE)ÂNot for Use With a Designated Financial Institution	2012 5304SIMPLE.pdf		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100,000	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	Previously Approved
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	640,000	640,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2012 Form 5304-SIMPLE Burden	2012 5304SIMPLE burden.PDF	12/11/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.