Information Collection

Registration Statement Under The Securities Act Of 1933 And Investment Company Act Of 1940 For Insurance Company Separate Accounts Issuing Variable Annuity Contracts -- Form N-4

IC 159365 under ICR 199405-3235-004 · OMB 3235-0318.

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Information Collection (IC) Details

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IC Title:	REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 AND INVESTMENT COMPANY ACT OF 1940 FOR INSURANCE COMPANY SEPARATE ACCOUNTS ISSUING VARIABLE ANNUITY CONTRACTS -- FORM N-4	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SEC 2125				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 288	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	288	105	183
Annual IC Time Burden (Hours)	40,118	14,626	25,492
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.