Information Collection

Notice of Availability of Separate Payments for Contraceptive Services

IC 256648 under ICR 202210-1545-017 · OMB 1545-2307.

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Information Collection (IC) Details

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IC Title:	Notice of Availability of Separate Payments for Contraceptive Services	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 26 CFR 54.9815-2713(a)(1)(iv)

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: 27	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	295,153	295,153
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	89,579	89,579

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