Health Coverage Tax Credit Registration Form

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Health Coverage Tax Credit Registration Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 4980

Information Collection 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 %

	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

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.