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REG-118315-12 (FINAL), Health Insurance Providers Fee
REG-118315-12 (FINAL), Health Insurance Providers Fee and Form 8963, Report of Health Insurance Provider Information
OMB: 1545-2249
IC ID: 207129
OMB.report
TREAS/IRS
OMB 1545-2249
ICR 201401-1545-021
IC 207129
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2249 can be found here:
2020-11-27 - Extension without change of a currently approved collection
2017-06-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
REG-118315-12 (FINAL), Health Insurance Providers Fee
Agency IC Tracking Number:
ah-XXXX-036
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
26 CFR 57
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
800
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
800
0
0
0
0
800
Annual IC Time Burden (Hours)
400
0
0
0
0
400
Annual IC Cost Burden (Dollars)
0
0
0
0
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.