Information Collection

TD 9645, Rules relating to additional Medicare tax: Individuals and all other respondents

IC 199155 under ICR 201607-1545-006 · OMB 1545-2097.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2097 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
T_D_9645.doc	Other-T D 9645 Final

IC Title:

TD 9645, Rules relating to additional Medicare tax: Individuals and all other respondents

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 31.6205-1 26 CFR 31.6402(a)-2 26 CFR 31.6413(a)-1 26 CFR 31.6413(a)-2 26 CFR 31.6011(a)1

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
Other-T D 9645 Final			T_D_9645.doc		No		Paper Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,575,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,575,000	-325,000	1,900,000
Annual IC Time Burden (Hours)	1,575,000	-325,000	1,900,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.