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For you and your family
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EINs and other information

Filing For Individuals

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For you and your family
Standard mileage and other information

Forms and Instructions

Individual Tax Return
Request for Taxpayer Identification Number (TIN) and Certification
Single and Joint Filers With No Dependents
Employee's Withholding Allowance Certificate

 

Request for Transcript of Tax Returns
Employer's Quarterly Federal Tax Return
Installment Agreement Request
Wage and Tax Statement

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Amend/Fix Return
Apply for Power of Attorney
Apply for an ITIN
Rules Governing Practice before IRS

About Form 8928, Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code

Group health plans or employers file this form to report the tax due on the following failures.

  • A failure to provide a level of coverage of the costs of pediatric vaccines (as defined in section 2612 of the Public Health Services Act) that is not below the coverage provided as of May 1, 1993.
  • A failure to satisfy continuation coverage requirements under section 4980B.
  • A failure to meet portability, access, renewability, and market reform requirements under sections 9801, 9802, 9803, 9811, 9812, 9813, and 9815.
  • A failure to make comparable Archer MSA contributions under section 4980E.
  • A failure to make comparable health savings account (HSA) contributions under section 4980G.

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Recent Developments

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Other Items You May Find Useful

All Revisions for Form 8928

Form 7004, Application for Automatic Extension of Time To File Certain Business Income Tax, Information, and Other Returns

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Comment on Form 8928

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