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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Form 8941 - Credit for Small Employer Health Insurance Premiums
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
i8941_IRSWEB_2011_OMB2198.pdf
Yes
No
Printable Only
Other-Worksheets
Worksheets for Form 8941.pdf
Yes
No
Fillable Printable
Form
8941
Credit for Small Employer Health Insurance Premiums
f8941_IRSWEB_2011_OMB2198.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,000,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Farms, Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
95 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,046,964
0
0
0
0
3,046,964
Annual IC Time Burden (Hours)
40,189,456
0
0
0
0
40,189,456
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Burden for Form 8941
f8941_Burden_2011_OMB2198.pdf
04/17/2011
Burden for worksheets
burden for worksheets of Form 8941.pdf
10/26/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.