Information Collection

Applicable Insurance Contracts Information Return

IC 181019 under ICR 200707-1545-001 · OMB 1545-2083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2083 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 8921 Applicable Insurance Contracts Information Return	Form
F8921_Instr_052507.pdf	Instruction
Form 8921 Applicable Insurance Contracts Information Return F8921_052507.pdf	Form

IC Title:

Applicable Insurance Contracts Information Return

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Form	Form 8921	Applicable Insurance Contracts Information Return	F8921_052507.pdf		No		Fillable Printable
Instruction			F8921_Instr_052507.pdf		No		Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	50,000	50,000
Annual IC Time Burden (Hours)	1,794,500	1,794,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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