Form 8941 - Credit for Small Employer Health Insurance Premiums

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Information Collection (IC) Details

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IC Title:	Form 8941 - Credit for Small Employer Health Insurance Premiums	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	3,046,964	3,046,964
Annual IC Time Burden (Hours)	40,189,456	40,189,456
Annual IC Cost Burden (Dollars)	0	0

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