Information Collection

Form 990-BL-- Information and Initial Excise Tax Return for Black Lung Benefit Trusts and Certain Related Persons

IC 16806 under ICR 201411-1545-003 · OMB 1545-0049.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0049 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 990-BL Form 990-BL-- Information and Initial Excise Tax Return for Black Lung Benefit Trusts and Certain Related Persons	Form
Form 990BL Intructions (2014).pdf	Instruction
990-BL Information and Initial Excise Tax Return forBlack Lung Form 990BL (2014).pdf	Form
Burden (Form 990BL and Schedule A).PDF 2011 Burden Form 990-BL	IC Document
Summary of Changes.pdf Summary of changes	IC Document

IC Title:

Form 990-BL-- Information and Initial Excise Tax Return for Black Lung Benefit Trusts and Certain Related Persons

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 53.6011 26 CFR 53.6071-1 26 CFR 1.6033-2(a)(2)(i) 26 CFR 53.6071-1(d)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	990-BL	Information and Initial Excise Tax Return forBlack Lung Benefit Trusts and Certain Related Persons	Form 990BL (2014).pdf		Yes	No	Fillable Printable
Instruction			Form 990BL Intructions (2014).pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	22	-4	26
Annual IC Time Burden (Hours)	754	201	553
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2011 Burden Form 990-BL	Burden (Form 990BL and Schedule A).PDF	11/05/2014
Summary of changes	Summary of Changes.pdf	11/17/2014

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