Information Collection

Monthly HCTC (Health Coverage Tax Credit) Group Registration Form

IC 192496 under ICR 201604-1545-005 · OMB 1545-1842.

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Information Collection (IC) Details

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IC Title:	Monthly HCTC (Health Coverage Tax Credit) Group Registration Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 4980

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	900	900
Annual IC Cost Burden (Dollars)	0	0

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