U.S. Departing Alien Income Tax Return

Forms and Documents

Document Name	Status
Form 1040-C U.S. Departing Alien Income Tax Return Form	Modified
Summary of changes to 1040C Instr.pdf Justification for No Material/Nonsubstantive Change	2009-03-26
Major Chgs_F1040C_Inst_2009.pdf Justification for No Material/Nonsubstantive Change	2009-02-17
Major Chgs_F1040C_2009.pdf Justification for No Material/Nonsubstantive Change	2009-02-17

IC Document Collections

IC ID	Document Title	Status
16878	U.S. Departing Alien Income Tax Return Form	Modified

ICR Details

OMB Control No: 1545-0086	ICR Reference No: 200902-1545-009
Status: Historical Active	Previous ICR Reference No: 200708-1545-023
Agency/Subagency: TREAS/IRS	Agency Tracking No: CB-0086-009
Title: U.S. Departing Alien Income Tax Return
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/27/2009
	Date Received in OIRA: 02/26/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	11/30/2010	11/30/2010
Responses	2,500	0	2,500
Time Burden (Hours)	14,177	0	11,632
Cost Burden (Dollars)	0	0	0

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Abstract: Form 1040-C is used by aliens departing the U.S. to report income received or expected to be received for the entire tax year. The data collected are used to ensure that the departing alien has no outstanding U.S. tax liability.

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Authorizing Statute(s): US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
   US Code: 26 USC 6851 Name of Law: Termination assessments of income tax
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 343 871, 222, 702 Name of Law: Tax Extenders and Alternative Minimum Tax Relief Act of 2008 (Div C)
PL: Pub.L. 110 - 245 301 Name of Law: Earned Income Credit
PL: Pub.L. 111 - 5 1001, 1003, 1007, 1008 Name of Law: The American Recovery and Reinvestment Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 29037	05/23/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 52430	09/13/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
U.S. Departing Alien Income Tax Return	1040-C	U.S. Departing Alien Income Tax Return

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ICR Summary of Burden

	Total Approved	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	2,500	2,500	0	0	0	0
Annual Time Burden (Hours)	14,177	11,632	2,545	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Form 1040-C is used by aliens departing the U.S. to report income received or expected to be received for the entire tax year. The Instructions have been updated to include the following provisions of PL 111-5, the American recovery and Reinvestment Act, signed by the President on Feb. 17, 2009. > Make Work Pay Credit (Sec. 1001 of the Act; IRC 36A) > Unemployment Comp. partly nontaxable (Sec. 1007 of the Act;IRC 85) > Addt'l Child Tax Credit revised (Sec. 1003 of the Act; IRC 24(d)) > Certain sales & excise taxes deductible (Sec. 1008 of the Act; IRC 164(a); IRC 63(c)) The result of these statutory changes will result in a total burden increase of 2,545 hours.

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Annual Cost to Federal Government: $27,141

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 02/26/2009

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