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

IC 134142 under ICR 198702-1840-002 · OMB 1840-0108.

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GUARANTEE AGENCY REQUEST FOR REIMBURSEMENT FOR CLAIMS PAID, UNDER AGREEMENT FOR FEDERAL REINSURANCE, RECOVERIES ON CLAIM PAID UNDER FED. REINSURANCE, & REIMB., ON DEATH & DISABILITY
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1189, 1189-1 No No
Form 1189-2 No No
Form 1189-3 No No


    

58 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,784 0 0 984 0 1,800
Annual IC Time Burden (Hours) 10,444 0 0 6,214 0 4,230
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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