SUPPORTING STATEMENT
(Form 13560)
OMB #1545-1891
CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION
Form 13560 is completed by HCTC Health Plan Administrator (HPA) and accompanies a return of funds in order to ensure proper handling. The HPA is to send the completed form to the Department of the Treasury for one of the following options: Send an HPA check, reversal of a EFT transactions, or return an uncashed Treasury check. This form serves as supporting documentation for any funds returned by an HPA and clarifies where the payment should be applied and why it is being sent.
Internal Revenue Code Sections 35 and 7527 enacted by Public Law 107-210, Trade Act of 2002, require the Internal Revenue Service to make the advance HCTC Program available to eligible individuals beginning August 1, 2003. The HCTC expired
January 1, 2014, but the Form 13560 will continued to be used help ensure that when an HPA returns funds, the payment will be applied correctly.
USE OF DATA
The information collected on Form 13560 will be used f by Treasury to ensure that returned funds are applied correctly.
USE OF IMPROVED INFORMATION TECHNOLOGY TO REDUCE BURDEN
There are no plans to provide electronic filing because electronic filing is not appropriate for the collection of information in this submission.
EFFORTS TO IDENTIFY DUPLICATION
We have attempted to eliminate duplication within the agency wherever possible.
METHODS TO MINIMIZE BURDEN ON SMALL BUSINESSES OR OTHER SMALL ENTITIES
Not applicable.
CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR POLICY ACTIVITIES
Not applicable.
7. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT WITH GUIDELINES IN 5 CFR 1320.5(d)(2)
Not applicable.
8. CONSULTATION WITH INDIVIDUALS OUTSIDE OF THE AGENCY ON AVAILABILITY OF DATA, FREQUENCY OF COLLECTION, CLARITY OF INSTRUCTIONS AND FORMS, AND DATA ELEMENTS
In response to the Federal Register notice dated August 22, 2013 (78 FR 52236), we received no comments during the comment period regarding Form 13560.
9. EXPLANATION OF DECISION TO PROVIDE ANY PAYMENT OR GIFT TO RESPONDENTS
Not applicable
10. ASSURANCE OF CONFIDENTIALITY OF RESPONSES
Generally, tax returns and tax return information are confidential as required by 26 USC 6103.
11. JUSTIFICATION OF SENSITIVE QUESTIONS
A privacy impact assessment (PIA) has been conducted for information collected under this request as part of the “Health Coverage Tax Credit Program (HCTC)” system and a Privacy Act System of Records notice (SORN) has been issued for this system under IRS 22.012–Health Coverage Tax Credit Program Records. The Department of Treasury PIAs can be found at http://www.treasury.gov/privacy/PIAs/Pages/default.aspx.
Title 26 USC 6109 requires inclusion of identifying numbers in returns, statements, or other documents for securing proper identification of persons required to make such returns, statements, or documents and is the authority for social security numbers (SSNs) in IRS systems.
12. ESTIMATED BURDEN OF INFORMATION COLLECTION
Number of Time Per
Responses Response Total Hours
Form 13560 200 0.25 50
Estimates of the annualized cost to respondents for the hour burdens shown are not available at this time.
13. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS
As suggested by OMB, our Federal Register notice dated August 22, 2013 (78 FR 52236), requested public comments on estimates of cost burden that are not captured in the estimates of burden hours, i.e., estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide information. However, we did not receive any response from taxpayers on this subject. As a result, estimates of the cost burdens are not available at this time.
14. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT
The primary cost to the government consists of the cost of printing Form 13560. We estimate the cost of printing the form is $100.00.
15. REASONS FOR CHANGE IN BURDEN
There is no change in the paperwork burden previously approved by OMB. We are making this submission to renew the OMB approval.
16. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION
Not applicable.
17. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE
We believe that displaying the OMB expiration date is inappropriate because it could cause confusion by leading taxpayers to believe that the statutes/regulation sunsets as of the expiration date. Taxpayers are not likely to be aware that the Service intends to request renewal of OMB approval and obtain a new expiration date before the old one expires.
18. EXCEPTIONS TO THE CERTIFICATION STATEMENT
Not applicable.
Note: The following paragraph applies to all of the collections of information in this submission:
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless the collection of information displays a valid OMB control number. Books or records relating to a collection of information must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103.
| File Type | application/msword |
| File Title | SUPPORTING STATEMENT (Forms 13560 and 13561) |
| Author | bsyfb |
| Last Modified By | Wolfgang, Dawn |
| File Modified | 2014-03-24 |
| File Created | 2014-03-24 |