Information Collection

Terrorism Risk Insurance Program Loss Reporting

IC 39047 under ICR 200706-1505-001 · OMB 1505-0200.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0200 can be found here:

Documents and Forms

Document Name Document Type
Form TRIP-02 Terrorism Risk Insurance Program Loss Reporting Form and Instruction
TRIP-02 Terrorism Risk Insurance Program Certification of Loss ( certification_of_loss.pdf www.treas.gov/offices/domestic-finance/financial-institution/terrorism-insurance/pdf/certification_of_loss.pdf Form and Instruction
TRIP-01 Inititial Notice of Insured Loss notice_of_insured_loss.pdf www.treas.gov/offices/domestic-finance/financial-institution/terrorism-insurance/pdf/notice_of_insured_loss.pdf Form and Instruction
Schedule C Formats IC Document
schedule_b.pdf Schedule B IC Document
schedule_a.pdf Schedule A IC Document
schedule_c.pdf Schedule C (Instructions) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Terrorism Risk Insurance Program Loss Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	TRIP-02	Terrorism Risk Insurance Program Certification of Loss (and Schedules A, B and C)	certification_of_loss.pdf	http://www.treas.gov/offices/domestic-finance/financial-institution/terrorism-insurance/pdf/certification_of_loss.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP-01	Inititial Notice of Insured Loss	notice_of_insured_loss.pdf	http://www.treas.gov/offices/domestic-finance/financial-institution/terrorism-insurance/pdf/notice_of_insured_loss.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	4,200	4,200
Annual IC Cost Burden (Dollars)	1,100,000	1,100,000

Documents for IC

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