View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	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
Form	8941	Credit for Small Employer Health Insurance Premiums	f8941--2023-00-00 (1).pdf		Yes	Yes	Fillable Fileable
Instruction			i8941--2023-00-00.pdf		Yes	No	Printable Only

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: 315	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Farms, Not-for-profit institutions, Businesses or other for-profits

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	315	0	0	-180,685	0	181,000
Annual IC Time Burden (Hours)	3,544	0	0	-2,032,706	0	2,036,250
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
REG-113792-13	REG-113792-13.pdf	01/25/2024
Notice 2010-44	Notice 2010-44.pdf	01/25/2024
Notice 2010-82	Notice 2010-82.pdf	01/25/2024
TD 9672	TD 9672.pdf	01/25/2024

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