Information Collection

Form 1099-LTC - Long-Term Care and Accelerated Death Benefits.

IC 18587 under ICR 201305-1545-035 · OMB 1545-1519.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1519 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1099-LTC Form 1099-LTC - Long-Term Care and Accelerated Death Benefits.	Form
Instr 1099ltc 2015.pdf	Instruction
General Instructions OMB page.pdf	Other-null
1099-LTC Long-Term Care and Accelerated Death Benefits Form 1099-LTC 2015.pdf	Form
Burden 2013.pdf Burden Computation 2013	IC Document

IC Title:

Form 1099-LTC - Long-Term Care and Accelerated Death Benefits.

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1099-LTC	Long-Term Care and Accelerated Death Benefits	Form 1099-LTC 2015.pdf	Yes	Yes	Fillable Fileable
Instruction			Instr 1099ltc 2015.pdf	Yes	No	Printable Only
Other-null			General Instructions OMB page.pdf	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	292,500	213,453	79,047
Annual IC Time Burden (Hours)	67,275	49,094	18,181
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden Computation 2013	Burden 2013.pdf	09/24/2013

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