Health Coverage Tax Credit (HCTC) Advance Payments

Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1813 can be found here:

Documents and Forms

Document Name Document Type
Form 1099-H (2012) Health Coverage Tax Credit (HCTC) Advance Payments Form
INST_1099-H_2012.pdf Instruction
INST_1099-H_2013.pdf Instruction
1099-H (2012) Health Coverage Tax Credit (HCTC) Advance Payments Form_1099-H_2012.pdf Form
1099-H (2013) Health coverage Tax Credit (HCTC) Advance Payments Form_1099-H_2013.pdf Form
brdn_spec.pdf Burden Computation IC Document

Information Collection (IC) Details

IC Title:	Health Coverage Tax Credit (HCTC) Advance Payments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 6103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1099-H (2012)	Health Coverage Tax Credit (HCTC) Advance Payments	Form_1099-H_2012.pdf	Yes	Yes	Fillable Fileable
Instruction			INST_1099-H_2012.pdf	Yes	No	Printable Only
Form	1099-H (2013)	Health coverage Tax Credit (HCTC) Advance Payments	Form_1099-H_2013.pdf	Yes	Yes	Fillable Fileable
Instruction			INST_1099-H_2013.pdf	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	110,000	110,000
Annual IC Time Burden (Hours)	33,000	33,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Burden Computation	brdn_spec.pdf	07/23/2013

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