Information Collection

Patient Protection and Affordable Care Act Patient Protection Notice (TD 9951)

IC 193323 under ICR 202111-1545-007 · OMB 1545-2181.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2181 can be found here:

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Patient Protection and Affordable Care Act Patient Protection Notice (TD 9951)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 54.9815â2719A(b)(3)(iii)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 28,272	Number of Respondents for Small Entity: 27,355

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 58 %

	Approved	Program Change Due to New Statute	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	128,133	-564,874	693,007
Annual IC Time Burden (Hours)	3,534	-1,639	5,173
Annual IC Cost Burden (Dollars)	1,602	-3,769	5,371

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.