Credit for Small Employer Health Insurance Premiums

Form 8941 - Credit for Small Employer Health Insurance Premiums

Documents and Forms

Document Name Document Type
Form 8941 Credit for Small Employer Health Insurance Premiums Form
i8941--2023-00-00.pdf Instruction
i8941--2023-00-00.pdf Instruction
8941 Credit for Small Employer Health Insurance Premiums f8941--2023-00-00 (1).pdf Form
8941 Credit for Small Employer Health Insurance Premiums f8941--2023-00-00 (1).pdf Form
REG-113792-13.pdf REG-113792-13 IC Document
REG-113792-13.pdf REG-113792-13 IC Document
Notice 2010-44.pdf Notice 2010-44 IC Document
Notice 2010-44.pdf Notice 2010-44 IC Document
Notice 2010-82.pdf Notice 2010-82 IC Document
Notice 2010-82.pdf Notice 2010-82 IC Document
TD 9672.pdf TD 9672 IC Document
TD 9672.pdf TD 9672 IC Document

Information Collection (IC) Details

IC Title:	Credit for Small Employer Health Insurance Premiums	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	8941	Credit for Small Employer Health Insurance Premiums	f8941--2023-00-00 (1).pdf		Yes	Yes	Fillable Fileable
Instruction			i8941--2023-00-00.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 315	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Farms, Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	315	-180,685	181,000
Annual IC Time Burden (Hours)	3,544	-2,032,706	2,036,250
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.