CLASS EXEMPTION 78-19--CERTAIN TRANSACTIONS INVOLVING INSURANCE COMPANY POOLED SEPARATE ACCOUNT

ICR 198705-1210-005

OMB: 1210-0054

Federal Form Document

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ICR Details
1210-0054 198705-1210-005
Historical Active 198402-1210-003
DOL/EBSA
CLASS EXEMPTION 78-19--CERTAIN TRANSACTIONS INVOLVING INSURANCE COMPANY POOLED SEPARATE ACCOUNT
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 08/18/1987
Retrieve Notice of Action (NOA) 05/19/1987
  Inventory as of this Action Requested Previously Approved
02/28/1990 02/28/1990
1 0 0
1 0 0
0 0 0

THIS EXEMPTION ALLOWS PARTIES IN INTEREST OF AN EMPLOYEE BENEFIT PLAN THAT INVESTS IN AN INSURED POOLED SEPARATE ACCOUNT TO ENGAGE IN TRANSACTIONS WITH THE SEPARATE ACCOUNT IF THE PLAN'S PARTICIPATION IN THE SEPARATE ACCOUNT DOES NOT EXCEED SPECIFIC LIMITS. SIX YEAR RECORDKEEPING IS REQUIRED.

None
None


No

1
IC Title Form No. Form Name
CLASS EXEMPTION 78-19--CERTAIN TRANSACTIONS INVOLVING INSURANCE COMPANY POOLED SEPARATE ACCOUNT

  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 0 0 0 1 0
Annual Time Burden (Hours) 1 0 0 0 1 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.
05/19/1987


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