Information Collection

Settlement Of Insurance, Reconsideration Procedures

IC 152635 under ICR 198803-3068-001 · OMB 3068-0517.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3068-0517 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	SETTLEMENT OF INSURANCE, RECONSIDERATION PROCEDURES	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	200	155	45
Annual IC Time Burden (Hours)	800	620	180
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.