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Notice of Rescission
Affordable Care Act Notice Relating to Rescissions
OMB: 1545-2180
IC ID: 193319
OMB.report
TREAS/IRS
OMB 1545-2180
ICR 202009-1545-013
IC 193319
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2180 can be found here:
2024-01-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
TD 9491.pdf
TD 9491
IC Document
TD 9744.pdf
TD 9744
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Notice of Rescission
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
26 CFR 54.9815-2712
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:
100
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
1,533
0
0
0
0
1,533
Annual IC Time Burden (Hours)
20
0
0
0
0
20
Annual IC Cost Burden (Dollars)
250
0
0
0
0
250
Documents for IC
Title
Document
Date Uploaded
TD 9491
TD 9491.pdf
09/23/2020
TD 9744
TD 9744.pdf
09/23/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.