OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Form 14417 - Reimbursable Agreement - Non-Federal Entities; Form 14417-A - Statistics of Income - User Fee

ICR 202511-1545-017 · OMB 1545-2235 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 14417-A Statistics of Income - User Fee Form Modified Available
Form Form 14417 Reimbursable Agreement--Non-Federal Entities Form and Instruction Modified Available
1545-2235 Supporting Statement 2026.docx Supporting Statement A Uploaded 2026-04-30 Available
p1075--2021-11-00.pdf Supplementary Document Uploaded 2025-12-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
206240 Form 14417-A - Statistics of Income - User Fee Form ModifiedStatistics of Income - User Fee
203932 Form 14417--Reimbursable Agreement - Non-Federal Entities Form and Instruction ModifiedReimbursable Agreement--Non-Federal Entities
ICR Details
1545-2235 202511-1545-017
Received in OIRA 202211-1545-013
TREAS/IRS
Form 14417 - Reimbursable Agreement - Non-Federal Entities; Form 14417-A - Statistics of Income - User Fee
Extension without change of a currently approved collection   No
Regular 04/30/2026
  Requested Previously Approved
36 Months From Approved 05/31/2026
65 310
35 160
0 0
Information collected with this form will be used by the Internal Revenue Service (IRS) to enter into cost reimbursable agreements with state, local, foreign government, and commercial entities. The authority to perform services on a cost reimbursable basis is contained in Section 6103(p) of the Internal Revenue Code. Performance of services is authorized when consistent with the basic public obligations of the IRS.
US Code: 26 USC 7213A Name of Law: Unauthorized inspection of return or return information
   US Code: 26 USC 7213 Name of Law: Unauthorized disclosure return
   US Code: 26 USC 6108(b) Name of Law: Special Statistical Studies
   US Code: 26 USC 6103(p) Name of Law: Procedure and recordkeeping
   US Code: 26 USC 7431 Name of Law: Civil damages for unauthorized inspection or disclosure of returns and return information
  
None
Not associated with rulemaking
  90 FR 59523 12/18/2025
91 FR 22917 04/28/2026
No
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 65 310 0 0 -245 0
Annual Time Burden (Hours) 35 160 0 0 -125 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
Changes were made to the burden previously approved to update the estimated number of responses based on the most recent filing data. The annual number of responses requested is 65 (a decrease of 245 from the previously approved 310). No changes have been made to the form. The change in estimated responses results in an overall hourly burden decrease of 125 and current burden estimate is 35 hours as previously approved was 160 hours.
$42,408
No
    No
    No
No
No
No
No
Dyani Farrar 202 317-4324
  No
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.
04/30/2026