Information Collection

Designation Or Change Of Beneficiary For Second Seamen'a War Risk Ins.

IC 142754 under ICR 197709-2133-001 · OMB 2133-0014.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

DESIGNATION OR CHANGE OF BENEFICIARY FOR SECOND SEAMEN'A WAR RISK INS.

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MA-269				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60	30	30
Annual IC Time Burden (Hours)	15	0	15
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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

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