Information Collection

Health Coverage Tax Credit Registration Form

IC 41159 under ICR 200909-1545-001 · OMB 1545-1842.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1842 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 13441 Health Coverage Tax Credit Registration Form	Form and Instruction
13441 Health Coverage Tax Credit Form 13441_Health Coverage Tax Credit.pdf	Form and Instruction

IC Title:

Health Coverage Tax Credit Registration Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 4980

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	13441	Health Coverage Tax Credit	Form 13441_Health Coverage Tax Credit.pdf		No		Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,800	1,800
Annual IC Time Burden (Hours)	900	900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.