[Federal Register Volume 62, Number 198 (Tuesday, October 14, 1997)]
[Page 53380]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-27115]



Submission to OMB for Review; Comment Request

October 2, 1997.
    The Department of Treasury has submitted the following public 
information collection requirement(s) to OMB for review and clearance 
under the Paperwork Reduction Act of 1995, Public Law 104-13. Copies of 
the submission(s) may be obtained by calling the Treasury Bureau 
Clearance Officer listed. Comments regarding this information 
collection should be addressed to the OMB reviewer listed and to the 
Treasury Department Clearance Officer, Department of the Treasury, Room 
2110, 1425 New York Avenue, NW., Washington, DC 20220.

Internal Revenue Service (IRS)

    OMB Number: New.
    Form Number: IRS Form 8853.
    Type of Review: New collection.
    Title: Medical Savings Accounts and Long-Term Care Services and 
    Description: This form is used by individuals to report general 
information about their medical savings accounts (MSAs), to figure 
their MSA deductions, and to figure their taxable distributions from 
MSAs. The form is also used to report taxable payments from long-term 
care (LTC) contracts.
    Respondents: Individuals or households.
    Estimated Number of Respondents/Recordkeepers: 2,250,000.
    Estimated Burden Hours Per Respondent/Recordkeeper:

Recordkeeping..........................  1 hr., 6 min.                  
Learning about the law or the form.....  32 min.                        
Preparing the form.....................  1 hr., 14 min.                 
Copying, assembling, and sending the     20 min.                        
 form to the IRS.                                                       

    Frequency of Response: Annually.
    Estimated Total Reporting/Recordkeeping Burden: 3,877,500 hours.
    Clearance Officer: Garrick Shear, (202) 622-3869, Internal Revenue 
Service, Room 5571, 1111 Constitution Avenue, NW, Washington, DC 20224.
    OMB Reviewer: Alexander T. Hunt, (202) 395-7860, Office of 
Management and Budget, Room 10226, New Executive Office Building, 
Washington, DC 20503.
Lois K. Holland,
Departmental Reports Management Officer.
[FR Doc. 97-27115 Filed 10-10-97; 8:45 am]