[Federal Register Volume 77, Number 203 (Friday, October 19, 2012)]
[Notices]
[Page 64380]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-25697]


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DEPARTMENT OF THE TREASURY

Internal Revenue Service


Proposed Collection; Comment Request for Form 13441 and 13441-EZ

AGENCY: Internal Revenue Service (IRS), Treasury.

ACTION: Notice and request for comments.

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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 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 13441, Health Coverage Tax Credit Registration Form, and Form 
13441-EZ.

DATES: Written comments should be received on or before December 18, 
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 these forms and instructions should be directed to Allan 
Hopkins at Internal Revenue Service, room 6129, 1111 Constitution 
Avenue NW., Washington, DC 20224, or at (202) 622-6665, or through the 
internet at [email protected].

SUPPLEMENTARY INFORMATION:
    Title: Health Coverage Tax Credit Registration Form.
    OMB Number: 1545-1842.
    Form Number: 13441 and 13441-EZ.
    Abstract: Coverage Tax Credit Registration Form will be directly 
mailed to all individuals who are potentially eligible for the HCTC. 
Potentially eligible individuals will use this form to determine if 
they are eligible for the Health Coverage Tax Credit and to register 
for the HCTC program. Participation in this program is voluntary. This 
form will be submitted by the individual to the HCTC program office in 
a postage-paid, return envelope. We will accept faxed forms, if 
necessary. Additionally, recipients may call the HCTC call center for 
help in completing this form.
    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: Individuals or households.
    Estimated Number of Respondents: 5,400.
    Estimated Time per Response: 20 minutes.
    Estimated Total Annual Burden Hours: 1,800.
    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: October 15, 2012.
Allan Hopkins,
Tax Analyst.
[FR Doc. 2012-25697 Filed 10-18-12; 8:45 am]
BILLING CODE 4830-01-P