[Federal Register Volume 69, Number 68 (Thursday, April 8, 2004)]
[Notices]
[Pages 18676-18677]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-8000]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF THE TREASURY

Internal Revenue Service


Proposed Collection; Comment Request for Form 4852

AGENCY: Internal Revenue Service (IRS), Treasury.

[[Page 18677]]


ACTION: Notice and request for comments.

-----------------------------------------------------------------------

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 4852, Substitute for Form W-2, Wage and Tax Statement, or Form 
1099-R, Distributions From Pensions, Annuities, Retirement or Profit-
Sharing Plans, IRAs, Insurance Contracts, Etc.

DATES: Written comments should be received on or before June 7, 2004, 
to be assured of consideration.

ADDRESSES: Direct all written comments to Glenn P. Kirkland, Internal 
Revenue Service, room 6411, 1111 Constitution Avenue, NW., Washington, 
DC 20224.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the form and instructions should be directed to Carol Savage 
at Internal Revenue Service, room 6407, 1111 Constitution Avenue, NW., 
Washington, DC 20224, or at (202) 622-3945, or through the Internet at 
[email protected].

SUPPLEMENTARY INFORMATION: 
    Title: Substitute for Form W-2, Wage and Tax Statement, or Form 
1099-R, Distributions From Pensions, Annuities, Retirement or Profit-
Sharing Plans, IRAs, Insurance Contracts, Etc.
    OMB Number: 1545-0458.
    Form Number: Form 4852.
    Abstract: In the absence of a Form W-2 or 1099R from the employer 
or payer, Form 4852 is used by the taxpayer to estimate gross wages, 
pensions, annuities, retirement or IRA payments received as well as 
income or FICA tax withheld during the year. The form is attached to 
the tax return so the return can be processed through normal channels 
the same as those with Forms W-2 or 1099R attached.
    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, business or other for-
profit organizations, farms, and Federal, state, local or tribal 
governments.
    Estimated Number of Responses: 1,500,000.
    Estimated Time Per Response: 18 minutes.
    Estimated Total Annual Burden Hours: 450,000.
    The following paragraph applies to all of the collections of 
information covered by this notice:
    An agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless the collection of 
information displays a valid OMB control number. Books or records 
relating to a collection of information must be retained as long as 
their contents may become material in the administration of any 
internal revenue law. Generally, tax returns and tax return information 
are confidential, as required by 26 U.S.C. 6103.
    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 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; (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; and (e) 
estimates of capital or start-up costs and costs of operation, 
maintenance, and purchase of services to provide information.

    Approved: April 1, 2004.
Glenn P. Kirkland,
IRS Reports Clearance Officer.
[FR Doc. 04-8000 Filed 4-7-04; 8:45 am]
BILLING CODE 4830-01-P