Information Collection

Disclosures by Insurers to General Account Policyholders

IC 13477 under ICR 199911-1210-004 · OMB 1210-0114.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Disclosures by Insurers to General Account Policyholders

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:

table that charts list of 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: 104

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	123,500	123,500
Annual IC Time Burden (Hours)	1,204,369	1,204,369
Annual IC Cost Burden (Dollars)	30,000	30,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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