Information Collection

Form 4029

IC 16837 under ICR 202412-1545-004 · OMB 1545-0064.

Documents and Forms

Document Name Document Type
Form 4029 Form 4029 Form and Instruction
4029 Application for Exemption from Social Security and Medic Form 4029--2018-11-00.pdf Form and Instruction
4029 Application for Exemption from Social Security and Medic Form 4029--2018-11-00.pdf Form and Instruction
2024-4029-Burden-2024-09-30 10-19-54.pdf Burden Computation IC Document
2024-4029-Burden-2024-09-30 10-19-54.pdf Burden Computation IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 4029	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 31.6053-1 26 CFR 1.1402(h)-1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4029	Application for Exemption from Social Security and Medicare Taxes and Waiver of Benefits	Form 4029--2018-11-00.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,414	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,414	-340	3,754
Annual IC Time Burden (Hours)	3,449	-343	3,792
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Burden Computation	2024-4029-Burden-2024-09-30 10-19-54.pdf	12/03/2024

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