Information Collection

TD 9645, Rules relating to additional Medicare tax: Large and small entities

IC 222638 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⚠️ Notice: This information collection may be referencing outdated material.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
TD_9645_29Nov2013.pdf Treasury Decision 9645	IC Document

IC Title:

TD 9645, Rules relating to additional Medicare tax: Large and small entities

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 31.6205-1

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

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 325,000

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
Annual Number of Responses for this IC	325,000	325,000
Annual IC Time Burden (Hours)	325,000	325,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Treasury Decision 9645	TD_9645_29Nov2013.pdf	07/29/2016

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