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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 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                         *Dawn.E.Bidne@irs.gov.*

# 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