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Form 13973

  1. Country USA
  2. Language English
  3. Activity Taxes
  4. Department Internal Revenue Service
Form 13973

Health Coverage Tax Credit (HCTC) Blank Payment Coupon

Rev. November 2016

Form 13973 is a Health Coverage Tax Credit (HCTC) payment coupon issued by the Department of the Treasury-Internal Revenue Service. It is designed for individuals who have received an enrollment notification letter from the IRS and have successfully enrolled in the HCTC Program. The form requires users to complete their HCTC Participant Identification Number, name, street address, city, state, zip code, and amount paid. Once completed, the form should be printed, cut off the payment coupon, and sent with a check payable to US Treasury – HCTC to the provided address in St. Louis, MO. The document also outlines accepted payment methods, failure to provide required information, privacy act notice, and paperwork reduction act notice.

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ABOUT

Tax forms

Form 13973 is one of Tax forms that are documents used to report information related to taxes to the relevant tax authority. There are various types of tax forms, including federal, state, and local tax forms, which can vary depending on the taxpayer's circumstances and location.

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