GUARANTEE AGENCY REQUEST FOR REIMBURSEMENT FOR CLAIMS PAID REQUEST FOR REIMBURSEMENT UNDER AGREEMENT FOR FED. REINSURANCE - REQUEST FOR REIMBURSE. ON DEATH/DISABILITY

ICR 198409-1840-018

OMB: 1840-0108

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1840-0108 198409-1840-018
Historical Active 198409-1840-017
ED/OPE
GUARANTEE AGENCY REQUEST FOR REIMBURSEMENT FOR CLAIMS PAID REQUEST FOR REIMBURSEMENT UNDER AGREEMENT FOR FED. REINSURANCE - REQUEST FOR REIMBURSE. ON DEATH/DISABILITY
No material or nonsubstantive change to a currently approved collection   No
Emergency 09/20/1984
Approved with change 09/20/1984
Retrieve Notice of Action (NOA) 09/20/1984
  Inventory as of this Action Requested Previously Approved
03/31/1987 03/31/1987 03/31/1987
1,800 0 1,800
4,230 0 3,190
0 0 0

ED FORM 1189 IS USED BY THE GUARANTEED AGENCY TO REQUEST REIMBURSEMENT ON CLAIMS PAID AND SHOULD ALWAYS ACCOMPANY THE ED 1189-1 AND 1189-3. THE 1189-1 IS USED FOR REIMBURSEMENT ON DEATH AND DISABILITY CLAIMS PRIOR TO DEC. 15, 1968 AND FOR ALL BANKRUPTCY CLAIMS. THE 1189-3 IS FOR REIMBURSEMENT OF DEATH AND DISABILITY CLAIMS AFTER DEC. 15, 1968.

None
None


No

  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 1,800 1,800 0 0 0 0
Annual Time Burden (Hours) 4,230 3,190 0 0 1,040 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.
09/20/1984


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