Information Collection Request

Long-Term Care and Accelerated Death Benefits

ICR 202506-1545-014 · OMB 1545-1519 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1099-LTC Long-Term Care and Accelerated Death Benefits Form Modified Available
Form 1099-LTC Form 1099-LTC - Long-Term Care and Accelerated Death Benefits. Form Modified Missing upstream
1545-1519 Supporting Statement-MM.docx Supporting Statement A Uploaded 2025-08-18 Available
1545-1519 Supporting Statement-MM.docx Supporting Statement A Uploaded 2025-08-18 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
18587 Form 1099-LTC - Long-Term Care and Accelerated Death Benefits. Form ModifiedLong-Term Care and Accelerated Death Benefits
18587 Form 1099-LTC - Long-Term Care and Accelerated Death Benefits. Form Modified
18587 Form 1099-LTC - Long-Term Care and Accelerated Death Benefits. Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2029 36 Months From Approved 01/31/2026
410,600 0 410,600
94,438 0 94,438
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Form 1099-LTC - Long-Term Care and Accelerated Death Benefits. 1099-LTC

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 410,600 410,600 0 0 0 0
Annual Time Burden (Hours) 94,438 94,438 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No