Information Collection

Registration Statement For Insurance Company Separate Accounts Issuing Variable Annuity Contracts As Unit Investment Trusts, Form N-4

IC 159367 under ICR 199411-3235-016 · OMB 3235-0318.

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Information Collection (IC) Details

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IC Title:	REGISTRATION STATEMENT FOR INSURANCE COMPANY SEPARATE ACCOUNTS ISSUING VARIABLE ANNUITY CONTRACTS AS UNIT INVESTMENT TRUSTS, 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	0	288
Annual IC Time Burden (Hours)	40,448	288	40,160
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.