Health Coverage Tax Credit (HCTC) Advance Payments

Health Coverage Tax Credit (HCTC) Advance Payments (Form 1099-H)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1813 can be found here:

Documents and Forms

Document Name Document Type
Form 1099-H (2017 Draft Health Coverage Tax Credit (HCTC) Advance Payments Form
Instructions for 1099-H.pdf Instruction
1099-H Health Coverage Tax Credit (HCTC) Advance Payments Form 1099-H.pdf Form
1099-H (2017 Draft Health coverage Tax Credit (HCTC) Advance Payments 2017 draft 1099-H.pdf Form
brdn_spec.pdf Burden Computation IC Document
Notice 2004-47.pdf Notice 2004-47 IC Document
Notice 2005-50.pdf Notice 2005-50 IC Document
Notice 2016-2.pdf Notice 2016-2 IC Document
RP 2004-12.pdf RP 2004-12 IC Document

Information Collection (IC) Details

IC Title:	Health Coverage Tax Credit (HCTC) Advance Payments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1099-H (2017 Drafts)	Health coverage Tax Credit (HCTC) Advance Payments	2017 draft 1099-H.pdf	Yes	Yes	Fillable Fileable
Form	1099-H	Health Coverage Tax Credit (HCTC) Advance Payments	Form 1099-H.pdf	Yes	Yes	Fillable Fileable
Instruction			Instructions for 1099-H.pdf	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	49,000	-61,000	110,000
Annual IC Time Burden (Hours)	14,700	-18,300	33,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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