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Federal forms, ICRs, and supporting documents

Information Collection Request

Form 8921 - Applicable Insurance Contracts Information Return

ICR 200711-1545-012 · OMB 1545-2083 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form Form 8921 Applicable Insurance Contracts Information Return Form Modified Available
F8921_brdn_busi.pdf Supplementary Document Uploaded 2007-11-14 Available
IRC Section 6050V.pdf Supplementary Document Uploaded 2007-07-02 Available
PPA Act section 1211.pdf Supplementary Document Uploaded 2007-07-02 Available
Notice_2007_24.pdf Supplementary Document Uploaded 2007-07-02 Available
f8921_Sup Stmnt2.doc Supporting Statement A Uploaded 2007-11-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
181019 Applicable Insurance Contracts Information Return Form Modified
ICR Details
1545-2083 200711-1545-012
Historical Active 200707-1545-001
TREAS/IRS CB-2083-012
Form 8921 - Applicable Insurance Contracts Information Return
Extension without change of a currently approved collection   No
Regular
Approved without change 04/18/2008
Retrieve Notice of Action (NOA) 02/22/2008
  Inventory as of this Action Requested Previously Approved
04/30/2011 36 Months From Approved 04/30/2008
50,000 0 50,000
1,794,500 0 1,794,500
0 0 0
To comply with IRC section 6050V, as added by the Pension Protection Act of 2006, an applicable exempt organization must file a Form 8921 for each structured transaction under which it makes reportable acquisitions of applicable insurance contracts. The information gathered will be used by the Treasury to issue a two-year report to Congress.
US Code: 26 USC 6103 Name of Law: Confidentiality and disclosure of returns and return information
   US Code: 26 USC 6050V Name of Law: Information and Returns
  
PL: Pub.L. 109 - 280 1211 Name of Law: Pension Protection Act of 2006
Not associated with rulemaking
  72 FR 51905 09/11/2007
73 FR 9855 02/22/2008
No
1
IC Title Form No. Form Name
Applicable Insurance Contracts Information Return Form 8921 Applicable Insurance Contracts Information Return
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 1,794,500 1,794,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$100
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Johnny Cervantes 2026225021
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/22/2008