Information Collection

Report of Employer-Owned Life Insurance Contracts

IC 182415 under ICR 201107-1545-019 · OMB 1545-2089.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8925 Report of Employer-Owned Life Insurance Contracts	Form and Instruction
8925 Report of Employer-Owned Life Insurance Contracts 2010 8925.pdf	Form and Instruction
F8925_brdn_busi_Chg.pdf Form 8925 Burden Computation	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.6039I-1

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	8925	Report of Employer-Owned Life Insurance Contracts	2010 8925.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16,000

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: 10 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	16,000	16,000
Annual IC Time Burden (Hours)	71,360	71,360
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form 8925 Burden Computation	F8925_brdn_busi_Chg.pdf	08/31/2011

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