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TD 9724 - Summary of Benefits and Coverage Disclosures
TD 9724 - Summary of Benefits and Coverage Disclosures
OMB: 1545-2229
IC ID: 199118
OMB.report
TREAS/IRS
OMB 1545-2229
ICR 201703-1545-005
IC 199118
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2229 can be found here:
2019-04-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
TD 9575.pdf
TD 9575
IC Document
1545-2229 (TD 9724).pdf
TD 9724
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
TD 9724 - Summary of Benefits and Coverage Disclosures
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
26 CFR 54.9815-2715
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
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:
2,299,742
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
71,252,326
0
-213,552,795,227
0
0
213,624,047,553
Annual IC Time Burden (Hours)
431,553
0
3
0
0
431,550
Annual IC Cost Burden (Dollars)
9,273,266
0
-1,749,990,379,326
0
0
1,749,999,652,592
Documents for IC
Title
Document
Date Uploaded
TD 9575
TD 9575.pdf
12/11/2014
TD 9724
1545-2229 (TD 9724).pdf
04/05/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.