U.S. MUTUAL INSURANCE COMPANY INCOME TAX RETURN

ICR 198609-1545-015

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
130126 Migrated
ICR Details
1545-0566 198609-1545-015
Historical Active 198410-1545-018
TREAS/IRS
U.S. MUTUAL INSURANCE COMPANY INCOME TAX RETURN
Revision of a currently approved collection   No
Regular
Approved without change 10/20/1986
Retrieve Notice of Action (NOA) 09/22/1986
APPROVED WITH THE CONDITION THAT THE REVISIONS NOT BECOME EFFECTIVE UNTIL ENACTMENT OF THE TAX REFORM ACT. IN ADDITION, YOUR REQUESTS FOR CONTINUED USE OF PRIOR VERSIONS OF THE FORM AND TO OMIT PRINTING THE EXPIRATION DATE ON THE FORMS ARE GRANTED.
  Inventory as of this Action Requested Previously Approved
10/31/1989 10/31/1989 10/31/1987
1,627 0 1,627
21,581 0 19,565
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 ITS TAX. THE DATA IS USED TO VERIFY 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 1,627 1,627 0 0 0 0
Annual Time Burden (Hours) 21,581 19,565 0 2,016 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.
09/22/1986


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