CLAIM FOR INSURANCE AND ASSIGNMENT OF INSURED ACCOUNT

ICR 198108-3068-015

OMB: 3068-0027

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
152493 Migrated
ICR Details
3068-0027 198108-3068-015
Historical Active 198104-3068-014
FHLBB
CLAIM FOR INSURANCE AND ASSIGNMENT OF INSURED ACCOUNT
Revision of a currently approved collection   No
Regular
Approved without change 10/19/1981
Retrieve Notice of Action (NOA) 08/26/1981
  Inventory as of this Action Requested Previously Approved
10/31/1984 10/31/1984 12/31/1981
3,280 0 25,000
3,280 0 3,280
0 0 0

THE INSURANCE CLAIM AND ASSIGNMENT PACKAGE IS USED IN THE EVENT OF AN FSLIC PAYOUT OF INSURED ACCOUNTS. THE FORMS ARE REQUIRED TO ALLOCATE MONEY FOUND IN SEVERAL ACCOUNTS WITH THE SAME OR DIFFERENT CO-OWNERS. THE PURPOSE OF THE ALLOCATION IS TO DETERMINE THE INSURANCE COVERAGE O THE ACCOUNTS IN QUESTION AND TO MAKE PAYMENT IN ACCORDANCE WITH THE FSLIC REGULATIONS.

None
None


No

1
IC Title Form No. Form Name
CLAIM FOR INSURANCE AND ASSIGNMENT OF INSURED ACCOUNT FHLBB 681,, 683, 844,, 13L, 927, & 927A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,280 25,000 0 -21,720 0 0
Annual Time Burden (Hours) 3,280 3,280 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/26/1981


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