Form 13930 - Central Withholding Agreement; Form 13920 - Directed Withholding and Deposit Verification Form

Forms and Documents

Document Name	Status
Form 13920 Form 13920 Form and Instruction	New
Form 13930 Form 13930 Form and Instruction	Modified
Supporting Statement.doc Supporting Statement A	2013-03-01

IC Document Collections

IC ID	Document Title	Status
205283	Form 13920 Form and Instruction	New
183294	Form 13930 Form and Instruction	Modified

ICR Details

OMB Control No: 1545-2102	ICR Reference No: 201301-1545-005
Status: Historical Active	Previous ICR Reference No: 201012-1545-044
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Form 13930 - Central Withholding Agreement; Form 13920 - Directed Withholding and Deposit Verification Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/18/2013
	Date Received in OIRA: 03/25/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved	08/31/2014
Responses	10,400	0	2,300
Time Burden (Hours)	11,900	0	9,200
Cost Burden (Dollars)	0	0	0

---

Abstract: Form 13930 will be used by an individual who wishes to have a Central Withholding Agreement (CWA). This form instructs him regarding how to make his application for consideration. IRS Section 1441(a) requires withholding on certain payments of Non Resident Aliens (NRAs). Section 1.1441-4(b)(3) of the Income Tax Regulations provides that the withholding can be considered for adjustment if a CWA is applied for and granted. Form 13920 is used by withholding agents to verify to IRS that required deposits were made and give the amount of such deposits.

---

Authorizing Statute(s): US Code: 26 USC 1441 Name of Law: Withholding of tax on nonresident aliens.
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 2722	01/14/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 17764	03/22/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Form 13920	13920	Directed Withholding and Deposit Verification
Form 13930	13930	Central Withholding Agreement

---

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	10,400	2,300	0	8,100	0	0
Annual Time Burden (Hours)	11,900	9,200	0	2,700	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Form 13930 will be used by an individual who wishes to have a Central Withholding Agreement (CWA). Form 13920 is used by withholding agents to verify to IRS that required deposits were made and give the amount of such deposits. We are seeking OMB approval to add Form 13920 under this approval number. The addition of Form 13920 under the current approval number will result in an estimated burden increase of 2,700 hours and 8,100 responses per year.

---

Annual Cost to Federal Government: $0

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(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: 03/25/2013

---