OMB control number
Failure of Employer to Make Comparable Health Savings Account Contributions
OMB 1545-2146 · TREAS/IRS.
OMB 1545-2146
Form 8928 is used by employers, group health plans, HMOs, and third-party administrators to report and pay excise taxes due for failures under sections 4980B, 4980D, 4980E, and 4980G.
The latest form for Failure of Employer to Make Comparable Health Savings Account Contributions expires 2028-09-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Form 8928 Form 8928 - Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code
Supporting Statement_1545-2146_Clean.docx
Form 8928 - Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code All Historical Document Collections
| Extension without change of a currently approved collection | 2025-04-30 | ||
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Approved without change |
Extension without change of a currently approved collection | 2022-02-28 | |
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Approved without change |
Extension without change of a currently approved collection | 2018-10-30 | |
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Approved without change |
Revision of a currently approved collection | 2015-08-31 | |
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Approved without change |
Extension without change of a currently approved collection | 2012-05-31 | |
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Approved without change |
Revision of a currently approved collection | 2009-12-23 | |
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Preapproved |
New collection (Request for a new OMB Control Number) | 2009-03-31 |