Information Collection

Claim For Insurance And Assignment Of Insured Account

IC 152492 under ICR 198104-3068-014 · OMB 3068-0027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3068-0027 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	CLAIM FOR INSURANCE AND ASSIGNMENT OF INSURED ACCOUNT	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:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	FHLBB681	No	No
Form	FHLBB683	No	No
Form	FHLBB844	No	No
Form	FHLBB927	No	No
Form	FHLBB927A	No	No
Form	FHLBB680	No	No
Form	FHLBB13L	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	3,280	3,280
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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