Information Collection

Qualified Dividends Tax Worksheet

IC 191279 under ICR 202405-1545-024 · OMB 1545-0092.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0092 can be found here:

Documents and Forms

Document Name Document Type
Qualified Dividends Tax Worksheet.pdf Other-Worksheet

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Qualified Dividends Tax Worksheet	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Worksheet			Qualified Dividends Tax Worksheet.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-24,600	24,600
Annual IC Time Burden (Hours)	-107,502	107,502
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.