[Federal Register Volume 75, Number 23 (Thursday, February 4, 2010)]
[Notices]
[Page 5870]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-2324]


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DEPARTMENT OF THE TREASURY

Internal Revenue Service


Proposed Collection; Comment Request for the HCTC Medicare Family 
Member Registration Form

AGENCY: Internal Revenue Service (IRS), Treasury.

ACTION: Notice and request for comments.

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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 the HCTC 
Medicare Family Member Registration Form.

DATES: Written comments should be received on or before April 5, 2010 
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 notice should be directed to Dawn Bidne, at (202) 622-3933, 
or at Internal Revenue Service, room 6129, 1111 Constitution Avenue, 
NW., Washington, DC 20224, or through the Internet, at 
<a href="/cdn-cgi/l/email-protection#7e3a1f0910503b503c171a101b3e170c0d50191108"><span class="__cf_email__" data-cfemail="cd89acbaa3e388e38fa4a9a3a88da4bfbee3aaa2bb">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:
    Title: HCTC Medicare Family Member Registration Form.
    OMB Number: 1545-2162.
    Form Number: 14117.
    Abstract: This form will be used by the family members of HCTC 
eligible individuals under circumstances where the original candidate 
has died or become divorced from the family member. This form allows 
family member to begin the HCTC registration process by verifying the 
family member's eligibility.
    Current Actions: Extension of currently approved collection. There 
are no changes being made to the form at this time.
    Type of Review: Extension of currently approved collection.
    Affected Public: Business and for-profit.
    Estimated Number of Respondents: 2,400.
    Estimated Average Time per Respondent: 30 mins.
    Estimated Total Annual Burden Hours: 1,200 hrs.
    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: January 14, 2010.
R. Joseph Durbala,
IRS Supervisory Tax Analyst.
[FR Doc. 2010-2324 Filed 2-3-10; 8:45 am]
BILLING CODE 4830-01-P


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