U.S. MUTUAL INSURANCE COMPANY INCOME TAX RETURN

ICR 198111-1545-001

OMB: 1545-0566

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
130122 Migrated
ICR Details
1545-0566 198111-1545-001
Historical Active 198109-1545-178
TREAS/IRS
U.S. MUTUAL INSURANCE COMPANY INCOME TAX RETURN
Revision of a currently approved collection   No
Regular
Approved without change 11/11/1981
Retrieve Notice of Action (NOA) 11/02/1981
  Inventory as of this Action Requested Previously Approved
06/30/1983 06/30/1983 06/30/1983
1,200 0 1,200
13,043 0 13,004
0 0 0

A MUTUAL INSURANCE COMPANY (OTHER THAN A LIFE INSURANCE COMPANY AND OTHER THAN A FIRE, FLOOD, OR MARINE INSURANCE COMPANY), USES THIS FORM TO REPORT ITS INCOME AND FIGURE AND PAY TAX. THE DATA IS USED TO VERI THAT THE INCOME IS PROPERLY REPORTED AND THE CORRECT TAX IS PAID.

None
None


No

1
IC Title Form No. Form Name
U.S. MUTUAL INSURANCE COMPANY INCOME TAX RETURN 1120M

  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 1,200 1,200 0 0 0 0
Annual Time Burden (Hours) 13,043 13,004 0 39 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
11/02/1981


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