[Federal Register Volume 76, Number 223 (Friday, November 18, 2011)]
[Notices]
[Pages 71622-71623]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-29796]


-----------------------------------------------------------------------

DEPARTMENT OF THE TREASURY

Internal Revenue Service


Proposed Collection; Comment Request for Form 1099-SA

AGENCY: Internal Revenue Service (IRS), Treasury.

ACTION: Notice and request for comments.

-----------------------------------------------------------------------

SUMMARY: The Department of the Treasury, as part of its continuing 
effort to reduce paperwork and respondent burden, invites the general 
public and other Federal agencies to take this

[[Page 71623]]

opportunity to comment on proposed and/or continuing information 
collections, as required by the Paperwork Reduction Act of 1995, Public 
Law 104-13 (44 U.S.C. 3506(c)(2)(A)). Currently, the IRS is soliciting 
comments concerning Form 1099-SA, Distributions From an HSA, Archer MSA 
or Medical Advantage MSA.

DATES: Written comments should be received on or before January 17, 
2012 to be assured of consideration.

ADDRESSES: Direct all written comments to Yvette Lawrence, Internal 
Revenue Service, room 6129, 1111 Constitution Avenue NW., Washington, 
DC 20224.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the form and instructions should be directed to Allan Hopkins 
at (202) 622-6665, or at Internal Revenue Service, room 6129, 1111 
Constitution Avenue NW., Washington, DC 20224, or through the Internet, 
at [email protected].

SUPPLEMENTARY INFORMATION: 
    Title: Distributions From an HSA, Archer MSA or Medical Advantage 
MSA.
    OMB Number: 1545-1517.
    Form Number: 1099-SA.
    Abstract: This form is used to report distributions from a medical 
savings account as required by Internal Revenue Code section 220(h).
    Current Actions: There are no changes being made to the form at 
this time.
    Type of Review: Extension of a currently approved collection.
    Affected Public: Business or other for-profit organizations.
    Estimated Number of Responses: 25,839.
    Estimated Time per Response: 8 min.
    Estimated Total Annual Burden Hours: 3,618.
    The following paragraph applies to all of the collections of 
information covered by this notice:
    An agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless the collection of 
information displays a valid OMB control number. Books or records 
relating to a collection of information must be retained as long as 
their contents may become material in the administration of any 
internal revenue law. Generally, tax returns and tax return information 
are confidential, as required by 26 U.S.C. 6103.
    Request For Comments: Comments submitted in response to this notice 
will be summarized and/or included in the request for OMB approval. All 
comments will become a matter of public record. Comments are invited 
on: (a) Whether the collection of information is necessary for the 
proper performance of the functions of the agency, including whether 
the information shall have practical utility; (b) the accuracy of the 
agency's estimate of the burden of the collection of information; (c) 
ways to enhance the quality, utility, and clarity of the information to 
be collected; (d) ways to minimize the burden of the collection of 
information on respondents, including through the use of automated 
collection techniques or other forms of information technology; and (e) 
estimates of capital or start-up costs and costs of operation, 
maintenance, and purchase of services to provide information.

    Approved: November 14, 2011.
Allan Hopkins,
Tax Analyst.
[FR Doc. 2011-29796 Filed 11-17-11; 8:45 am]
BILLING CODE 4830-01-P