Information Collection

Application For Ordinary Life Insurance (modified Age 65)

IC 174417 under ICR 198209-2900-028 · OMB 2900-0166.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR ORDINARY LIFE INSURANCE (MODIFIED AGE 65)	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29-8700				No	No
Form	29-8485 &				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	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	Previously Approved
Annual Number of Responses for this IC	6,818	5,818	1,000
Annual IC Time Burden (Hours)	566	483	83
Annual IC Cost Burden (Dollars)	0	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.