Information Collection

Electronic Claim Filing System, Short-Term Insurance

IC 181666 under ICR 200708-3048-001 · OMB 3048-0025.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, Shorttermclaim_A.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_B.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_C.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_D.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_E.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_F.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_G.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_H.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction
EIB 07-01A, Sectio Electronic Claim Filing System, Short-Term Insurance EIB 07-01A, shorttermclaim_I.pdf tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Electronic Claim Filing System, Short-Term Insurance

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Form and Instruction	EIB 07-01A, Section I	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_I.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section A	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, Shorttermclaim_A.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section B	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_B.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section C	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_C.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section D	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_D.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section E	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_E.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section F	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_F.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section G	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_G.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable
Form and Instruction	EIB 07-01A, Section H	Electronic Claim Filing System, Short-Term Insurance	EIB 07-01A, shorttermclaim_H.pdf	https://tpccapps.exim.gov/apps/ecfs/ecfsprod.nsf/Home?OpenFrameset	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

Number of Respondents for Small Entity: 32

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	32	32
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.