Information Collection

TD 9590 (REG-131491-10) Health Insurance Premium Tax Credit

IC 198353 under ICR 201305-1545-029 · OMB 1545-2232.

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Information Collection (IC) Details

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IC Title:	TD 9590 (REG-131491-10) Health Insurance Premium Tax Credit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 1.36B-5

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: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15	-45	60
Annual IC Time Burden (Hours)	10,050	10,049	1
Annual IC Cost Burden (Dollars)	0	0	0

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