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###### Department of the Treasury

###### Internal Revenue Service

# AGENCY:

Internal Revenue Service (IRS), Treasury.

# ACTION:

Notice and request for comments.

# 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 8928, Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code.

# DATES:

Written comments should be received on or before October 5, 2009 to be assured of consideration.

# ADDRESSES:

Direct all written comments to R. Joseph Durbala, Internal Revenue Service, room 6129, 1111 Constitution Avenue NW., Washington, DC 20224.

# FOR FURTHER INFORMATION CONTACT:

                        Requests for additional information or copies of the form and instructions should be directed to Dawn Bidne, (202) 622-3933, at Internal Revenue Service, room 6129, 1111 Constitution Avenue NW., Washington, DC 20224, or through the Internet at                         *Dawn.E.Bidne@irs.gov*.                              ( print page 39144)    

# SUPPLEMENTARY INFORMATION:

*Title:*                     Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code.                

*OMB Number:*                     1545-2148.                

*Form Number:*                     Form 8928.                

*Abstract:*                     Form 8928 is used by employers, group health plans, HMOs, and third party administrators to report and pay excise taxes due for failures under sections 4980B, 4980D, 4980E, and 4980G.                

*Current Actions:*                     There is no change in the paperwork burden previously approved by OMB. This form is being submitted for renewal purposes.                

*Type of Review:*                     This is an extension of a previously approved collection.                

*Affected Public:*                     Businesses and other for-profit organizations, and not-for-profit institutions.                

*Estimated Number of Respondents:*                     100.                

*Estimated Time Per Respondent:*                     18 hours 33 minutes.                

*Estimated Total Annual Burden Hours:*                     1,858.                

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: July 28, 2009.

R. Joseph Durbala,

IRS Reports Clearance Officer.

[FR Doc. E9-18676 Filed 8-4-09; 8:45 am]

BILLING CODE 4830-01-P