50732 Federal Register / Vol. 82, No. 210 / Wednesday, November 1, 2017 / Notices 

IRS is soliciting comments concerning 

Form 5305A–SEP, Salary Reduction 

Simplified Employee Pension— 

Individual Retirement Accounts 

Contribution Agreement. 

DATES: Written comments should be 

received on or before January 2, 2018 to 

be assured of consideration. 

ADDRESSES: Direct all written comments 

to L. Brimmer, Internal Revenue 

Service, Room 6526, 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 Martha R. Brinson, 

at (202) 317–5753 or at Internal Revenue 

Service, Room 6526, 1111 Constitution 

Avenue NW., Washington, DC 20224, or 

through the Internet at 

Martha.R.Brinson@irs.gov. 

SUPPLEMENTARY INFORMATION: 

Title: Salary Reduction Simplified 

Employee Pension—Individual 

Retirement Accounts Contribution 

Agreement. 

OMB Number: 1545–1012. 

Form Number: 5305A–SEP. 

Abstract: Form 5305A–SEP is used by 

an employer to make an agreement to 

provide benefits to all employees under 

a Simplified Employee Pension (SEP) 

described in Internal Revenue Code 

section 408(k). This form is not to be 

filed with the IRS, but is to be retained 

in the employer’s records as proof of 

establishing a SEP and justifying a 

deduction for contributions made to the 

SEP. 

Current Actions: There are no changes 

being made to the form at this time. 

Type of Review: Extension of a 

currently approved collection. 

Affected Public: Business or other forprofit organizations and individuals. 

Estimated Number of Responses: 

100,000. 

Estimated Time per Respondent: 9 hr., 

43 min. 

Estimated Total Annual Burden 

Hours: 972,000. 

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: October 25, 2017. 

L. Brimmer, 

Senior Tax Analyst. 

[FR Doc. 2017–23715 Filed 10–31–17; 8:45 am] 

BILLING CODE 4830–01–P 

DEPARTMENT OF THE TREASURY 

Internal Revenue Service 

Proposed Extension of Information 

Collection Request Submitted for 

Public Comment; Information 

Reporting by Applicable Large 

Employers on Health Insurance 

Coverage Offered Under EmployerSponsored Plans 

AGENCY: Internal Revenue Service (IRS), 

Treasury. 

ACTION: Notice and request for 

comments. 

SUMMARY: The Internal Revenue Service, 

as part of its continuing effort to reduce 

paperwork and respondent burden, 

invites the 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. Currently, the IRS is 

soliciting comments concerning the 

requirements relating to the information 

reporting by applicable large employers 

on health insurance coverage offered 

under employer-sponsored plans. 

DATES: Written comments should be 

received on or before January 2, 2018 to 

be assured of consideration. 

ADDRESSES: Direct all written comments 

to L. Brimmer, Internal Revenue 

Service, Room 6526, 1111 Constitution 

Avenue NW., Washington, DC 20224. 

FOR FURTHER INFORMATION CONTACT: 

Requests for additional information or 

copies of the regulations should be 

directed to Tuawana Pinkston, at (202) 

317–6038 or at Internal Revenue 

Service, Room 6526, 1111 Constitution 

Avenue NW., Washington, DC 20224, or 

through the internet, at 

Tuawana.Pinkston@irs.gov. 

SUPPLEMENTARY INFORMATION: 

Title: Form 1094–C, Transmittal of 

Employer-Provided Health Insurance 

Offer and Coverage Information Returns, 

and 1095–C, Employer-Provided Health 

Insurance Offer and Coverage, and Form 

4423, Application for Filing Affordable 

Care Act (ACA) Information Returns. 

OMB Number: 1545–2251. 

Form Numbers: Forms 1094–C, 

1095–C, and 4423. 

Abstract: This program contains 

regulations providing guidance to 

employers that are subject to the 

information reporting requirements 

under section 6056 of the Internal 

Revenue Code, enacted by the Patient 

Protection and Affordable Care Act 

(Pub. L. 111–148 (124 Stat.119 (2010))). 

Section 6056 requires those employers 

to report to the IRS information about 

their compliance with the employer 

shared responsibility provisions of 

section 4980H of the Code and about the 

health care coverage, if any, they have 

offered employees. Section 6056 also 

requires those employers to furnish 

related statements to employees in order 

that employees may use the statements 

to help determine whether, for each 

month of the calendar year, they can 

claim on their tax returns a premium tax 

credit under section 36B of the Code 

(premium tax credit). 

Title: Form 1094–C. 

Current Actions: There is no change to 

this existing regulation. However, the 

agency has updated the number of 

respondents to reflect the most recent 

data available. 

Type of Review: Revision of a 

currently approved collection. 

Affected Public: Individuals or 

households, Business or other for-profit, 

and not-for-profit entities. 

Estimated Number of Respondents: 

400,000. 

Estimated Time per Respondent: 4 

hours. 

Estimated Total Annual Burden 

Hours: 1,600,000. 

Title: Form 1095–C. 

Current Actions: There is no change to 

this existing collection. However, the 

agency has updated the number of 

respondents to reflect the most recent 

data available. 

Type of Review: Revision of a 

currently approved collection. 

Affected Public: Individuals or 

households, Business or other for-profit, 

and not-for-profit entities. 


sradovich on DSK3GMQ082PROD with NOTICES
Federal Register / Vol. 82, No. 210 / Wednesday, November 1, 2017 / Notices 50733 

Estimated Number of Respondents: 

105,000,000. 

Estimated Time per Respondent: 12 

minutes. 

Estimated Total Annual Burden 

Hours: 21,000,000. 

Title: Form 4423. 

Current Actions: There is no change to 

this existing collection. 

Type of Review: Extension of a 

currently approved collection. 

Affected Public: Individuals or 

households, Business or other for-profit, 

and not-for-profit entities. 

Estimated Number of Respondents: 6. 

Estimated Time per Respondent: 20 

minutes. 

Estimated Total Annual Burden 

Hours: 2 hours. 

The following paragraph applies to all 

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 if 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 our 

request for Office of Management and 

Budget (OMB) approval of the relevant 

information collection. All comments 

will become a matter of public record. 

Please do not include any confidential 

or inappropriate material in your 

comments. We invite comments on: (a) 

Whether the collection of information is 

necessary for the proper performance of 

the agency’s functions, including 

whether the information has 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 

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 the requested information. 

Approved: October 25, 2017. 

L. Brimmer, 

Senior Tax Analyst. 

[FR Doc. 2017–23714 Filed 10–31–17; 8:45 am] 

BILLING CODE 4830–01–P 

DEPARTMENT OF THE TREASURY 

Office of the General Counsel; 

Appointment of Members of the Legal 

Division to the Performance Review 

Board, Internal Revenue Service 

Under the authority granted to me as 

Acting Chief Counsel of the Internal 

Revenue Service by the General Counsel 

of the Department of the Treasury by 

General Counsel Directive 15, pursuant 

to the Civil Service Reform Act, I have 

appointed the following persons to the 

Legal Division Performance Review 

Board, Internal Revenue Service Panel: 

1. Chairperson, William M. Paul, Acting 

Chief Counsel 

2. Scott Dinwiddie, Associate Chief 

Counsel (Income Tax and 

Accounting) 

3. Bruce Meneely, Division Counsel 

(Small Business & Self Employed) 

4. Mark Kaizen, Associate Chief Counsel 

(General Legal Services) 

5. Marjorie Rollinson, Associate Chief 

Counsel (International) 

Alternate—Joseph Spires, Deputy 

Division Counsel (Small Business & Self 

Employed) 

This publication is required by 5 

U.S.C. 4314(c)(4). 

Dated: October 20, 2017. 

William M. Paul, 

Acting Chief Counsel, Internal Revenue 

Service. 

[FR Doc. 2017–23717 Filed 10–31–17; 8:45 am] 

BILLING CODE 4830–01–P 

DEPARTMENT OF THE TREASURY 

Agency Information Collection 

Activities; Submission for OMB 

Review; Comment Request; Multiple 

IRS Information Collection Requests 

AGENCY: Departmental Offices, U.S. 

Department of the Treasury. 

ACTION: Notice. 

SUMMARY: The Department of the 

Treasury will submit the following 

information collection requests to the 

Office of Management and Budget 

(OMB) for review and clearance in 

accordance with the Paperwork 

Reduction Act of 1995, on or after the 

date of publication of this notice. The 

public is invited to submit comments on 

these requests. 

DATES: Comments should be received on 

or before December 1, 2017 to be 

assured of consideration. 

ADDRESSES: Send comments regarding 

the burden estimate, or any other aspect 

of the information collection, including 

suggestions for reducing the burden, to 

(1) Office of Information and Regulatory 

Affairs, Office of Management and 

Budget, Attention: Desk Officer for 

Treasury, New Executive Office 

Building, Room 10235, Washington, DC 

20503, or email at OIRA_Submission@

OMB.EOP.gov and (2) Treasury PRA 

Clearance Officer, 1750 Pennsylvania 

Ave. NW., Suite 8142, Washington, DC 

20220, or email at PRA@treasury.gov. 

FOR FURTHER INFORMATION CONTACT: 

Copies of the submissions may be 

obtained from Jennifer Leonard by 

emailing PRA@treasury.gov, calling 

(202) 622–0489, or viewing the entire 

information collection request at 

www.reginfo.gov. 

SUPPLEMENTARY INFORMATION: 

Internal Revenue Service (IRS) 

Title: Claim for Refund of Excise 

Taxes. 

OMB Control Number: 1545–1420. 

Type of Review: Revision of a 

currently approved collection. 

Abstract: IRC sections 6402, 6404, 

6511 and sections 301.6402–2, 

301.6404–1, and 301.6404–3 of the 

regulations, allow for refunds of taxes 

(except income taxes) or refund, 

abatement, or credit of interest, 

penalties, and additions to tax in the 

event of errors or certain actions by IRS. 

Form 8849 is used by taxpayers to claim 

refunds of excise taxes. 

Forms: Schedule 1 (Form 8849), 

Schedule 2 (Form 8849), Schedule 3 

(Form 8849), Schedule 5 (Form 8849), 

Schedule 6 (Form 8849), Schedule 8 

(Form 8849), Form 8849. 

Affected Public: Individuals or 

Households, Businesses or other forprofits. 

Estimated Total Annual Burden 

Hours: 942,860. 

Title: Form 945/945V: Annual Return 

of Withheld Federal Income Tax/ 

Voucher; Form 945–A: Annual Record 

of Federal Tax Liability; Form 945–X 

Annual Return of Withheld Federal 

Income Tax, Claim, Refund; TD8672. 

OMB Control Number: 1545–1430. 

Type of Review: Revision of a 

currently approved collection. 

Abstract: Form 945 is used to report 

income tax withholding on non-payroll 

payments including backup 

withholding and withholding on 

pensions, annuities, IRA’s, military 

retirement and gambling winnings. 

Form 945–V, Payment Voucher, is used 

if you are making a payment with Form 

945, Annual Return of Withheld Federal 

Income Tax. Form 945–A is used to 

report non payroll tax liabilities. Form 

945–X is used to correct errors made on 

Form 945, Annual Return of Withheld 

Federal Income Tax, for one year only. 

TD 8672, these final regulations require 


sradovich on DSK3GMQ082PROD with NOTICES