Guarantee Agency Request For Reimbursement For Claims Paid, Under Agreement For Federal Reinsurance, Recoveries On Claim Paid Under Fed. Reinsurance, & Reimb., On Death & Disability

GUARANTEE AGENCY REQUEST FOR REIMBURSEMENT FOR CLAIMS PAID, UNDER AGREEMENT FOR FEDERAL REINSURANCE, RECOVERIES ON CLAIM PAID UNDER FED. REINSURANCE, & REIMB., ON DEATH & DISABILITY

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	GUARANTEE AGENCY REQUEST FOR REIMBURSEMENT FOR CLAIMS PAID, UNDER AGREEMENT FOR FEDERAL REINSURANCE, RECOVERIES ON CLAIM PAID UNDER FED. REINSURANCE, & REIMB., ON DEATH & DISABILITY	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.	Available Electronically?	Can Be Submitted Electronically?
Form	1189, 1189-1	No	No
Form	1189-2	No	No
Form	1189-3	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 58	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,784	984	1,800
Annual IC Time Burden (Hours)	10,444	6,214	4,230
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.