[Federal Register Volume 79, Number 19 (Wednesday, January 29, 2014)]
[Notices]
[Pages 4811-4812]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-01638]


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DEPARTMENT OF THE TREASURY


Submission for OMB Review; Comment Request

January 23, 2014.
    The Department of the Treasury will submit the following 
information collection requests to the Office of Management and Budget 
(OMB) for review and clearance in accordance with the Paperwork 
Reduction Act of 1995, Public Law 104-13, on or after the date of 
publication of this notice.

DATES: Comments should be received on or before February 28, 2014 to be 
assured of consideration.

ADDRESSES: Send comments regarding the burden estimate, or any other 
aspect of the information collection, including suggestions for 
reducing the burden, to (1) Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attention: Desk Officer for 
Treasury, New Executive Office Building, Room 10235, Washington, DC 
20503, or email at [email protected] and (2) Treasury PRA 
Clearance Officer, 1750 Pennsylvania

[[Page 4812]]

Ave. NW., Suite 8140, Washington, DC 20220, or email at 
[email protected].

FOR FURTHER INFORMATION CONTACT: Copies of the submission(s) may be 
obtained by calling (202) 927-5331, email at [email protected], or the 
entire information collection request may be found at www.reginfo.gov.

Internal Revenue Service (IRS)

    OMB Number: 1545-NEW.
    Type of Review: New collection.
    Title: Declaration and Signature for Electronic Filing of Forms 
8947 and 8963.
    Form: 8453-R.
    Abstract: This is a new form established under Section 9010 of the 
Patient Protection and Affordable Care Act (PPACA), Public Law 111-148 
(124 Stat. 119 (2010)), as amended by section 10905 of PPACA, and as 
further amended by section 1406 of the Health Care and Education 
Reconciliation Act of 2010, Public Law 111-152 (124 Stat. 1029 (2010)), 
which requires that any covered entity engaged in the business of 
providing health insurance related to United States health risks must 
annually report its net premiums written. The purpose of the Form 8453-
R to authenticate the electronic filing of Form 8947, Report of Branded 
Prescription Drug Information, and Form 8963, Report of Health 
Insurance Provider Information.
    Affected Public: Private Sector: Businesses or other for-profits, 
Farms, Not-for-profit institutions.
    Estimated Annual Burden Hours: 4,131.
    OMB Number: 1545-2249.
    Type of Review: Revision of a currently approved collection.
    Title: Health Insurance Providers Fee.
    Form: 8963.
    Abstract: The Affordable Care Act imposes an annual fee on health 
insurance providers that provide health insurance for United States 
health risks (a covered entity). Rules which implement the Affordable 
Care Act, describe how the IRS will administer the health insurance 
providers fee. Recordkeeping requirements prescribed in Sec.  
57.2(e)(2) that each member of a controlled group are to maintain 
records of consent to the controlled group's selection of the 
designated entity. Reporting requirements through Form 8963, ``Report 
of Health Insurance Provider Information,'' is used report net premiums 
written for health insurance of United States health risks. The 
information reported will be used by the IRS to calculate the annual 
fee on health insurance providers.
    Affected Public: Private Sector: Businesses or other for-profits, 
Farms, Not-for-profit institutions.
    Estimated Annual Burden Hours: 17,808.

Dawn D. Wolfgang,
Treasury PRA Clearance Officer.
[FR Doc. 2014-01638 Filed 1-28-14; 8:45 am]
BILLING CODE 4830-01-P