[Federal Register Volume 61, Number 89 (Tuesday, May 7, 1996)]
[Notices]
[Pages 20553-20554]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11350]



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DEPARTMENT OF THE TREASURY

Proposed Collection; Comment Request for Form 4563

AGENCY: Internal Revenue Service (IRS), Treasury.

ACTION: Notice and request for comments.

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SUMMARY: The Department of the Treasury, as part of its continuing 
effort to reduce paperwork and respondent burden, invites the general 
public and other Federal agencies to take this opportunity to comment 
on proposed and/or continuing information collections, as required by 
the Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 
3506(c)(2)(A)). Currently, the IRS is soliciting comments concerning 
Form 4563, Exclusion of Income for Bona Fide Residents of American 
Samoa.

DATES: Written comments should be received on or before July 8, 1996 to 
be assured of consideration.

ADDRESSES: Direct all written comments to Garrick R. Shear, Internal 
Revenue Service, room 5571, 1111 Constitution Avenue NW., Washington, 
DC 20224.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the form(s) and instructions should be directed to Martha R. 
Brinson, (202) 622-3869, Internal Revenue Service, room 5571, 1111 
Constitution Avenue NW., Washington, DC 20224.

SUPPLEMENTARY INFORMATION:
    Title: Exclusion of Income for Bona Fide Residents of American 
Samoa.
    OMB Number: 1545-0173.
    Form Number: Form 4563.
    Abstract: This form is used by bona fide residents of American 
Samoa to exclude income from sources within American Samoa, Guam, and 
the Commonwealth of the Northern Mariana Islands to the extent 
specified in Internal Revenue Code section 931. This information is 
used by the Service to determine if an individual is eligible to 
exclude possession source income.
    Current Actions: There are no changes being made to the form at 
this time.
    Type of Review: Extension of a currently approved collection.
    Affected Public: Individuals or households.
    Estimated Number of Respondents: 100.
    Estimated Time per Respondent: 1 hr. 21 min.
    Estimated Total Annual Burden Hours: 135.

REQUEST FOR COMMENTS: Comments submitted in response to this notice 
will be summarized and/or included in the request for OMB approval. All 
comments will become a matter of

[[Page 20554]]

public record. Comments are invited on: (a) Whether the collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
collection of information; (c) ways to enhance the quality, utility, 
and clarity of the information to be collected; and (d) ways to 
minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques or other 
forms of information technology.

    Approved: April 29, 1996.
Garrick R. Shear,
IRS Reports Clearance Officer.
[FR Doc. 96-11350 Filed 5-6-96; 8:45 am]
BILLING CODE 4830-01-U