[Federal Register Volume 61, Number 142 (Tuesday, July 23, 1996)]
[Notices]
[Page 38244]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-18567]


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DEPARTMENT OF THE TREASURY

Submission To OMB for Review; Comment Request

July 15, 1996.
    The Department of Treasury has submitted the following public 
information collection requirement(s) to OMB for review and clearance 
under the Paperwork Reduction Act of 1995, Public Law 104-13. Copies of 
the submission(s) may be obtained by calling the Treasury Bureau 
Clearance Officer listed. Comments regarding this information 
collection should be addressed to the OMB reviewer listed and to the 
Treasury Department Clearance Officer, Department of the Treasury, Room 
2110, 1425 New York Avenue, NW., Washington, DC 20220.

Internal Revenue Service (IRS)

    OMB Number: 1545-0173
    Form Number: IRS Form 4563
    Type of Review: Extension
    Title: Exclusion of Income for Bona Fide Residents of American 
Samoa
    Description: Used by bona fide residents of American Samoa whose 
income is from sources within American Samoa, Guam, and 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.
    Respondents: Individuals or households
    Estimated Number of Respondents/Recordkeepers: 100.
    Estimated Burden Hours Per Respondent/Recordkeeper:

      Recordkeeping--33 min.
      Learning about the law or the form--7 min.
      Preparing the form--25 min.
      Copying, assembling, and sending the form to the IRS--17 min.

    Frequency of Response: Annually
    Estimated Total Reporting/Recordkeeping Burden: 137 hours
    Clearance Officer: Garrick Shear (202) 622-3869, Internal Revenue 
Service, Room 5571, 1111 Constitution Avenue, N.W., Washington, DC 
20224.
    OMB Reviewer: Milo Sunderhauf (202) 395-7340, Office of Management 
and Budget, Room 10226, New Executive Office Building, Washington, DC 
20503.
Dale A. Morgan,
Departmental Reports, Management Officer.
[FR Doc. 96-18567 Filed 7-22-96; 8:45 am]
BILLING CODE 4830-01-P