Information Collection

War Risk Insrance, Applications and Related Information

IC 26586 under ICR 200709-2133-002 · OMB 2133-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2133-0011 can be found here:

Documents and Forms

Document Name Document Type
Form MA-355 War Risk Insrance, Applications and Related Information Form
MA-355 Underwriting Agency Agreement form_ma355.pdf Form
MA-528 Application for War Risk Insurance form_ma528.pdf Form
MA-742 Owner's Contract of Commitment form_ma742.pdf Form
MA-828 Vessel Data form_ma828.pdf Form
MA-942 Interim Binder of Insurance form_ma942.pdf Form
2133 0011 Supporting Statement.doc Supplementary Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	War Risk Insrance, Applications and Related Information	Agency IC Tracking Number:	2133-0011

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 46 CFR 308

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MA-355	Underwriting Agency Agreement	form_ma355.pdf	Yes	Yes	Fillable Fileable
Form	MA-528	Application for War Risk Insurance	form_ma528.pdf	Yes	Yes	Fillable Fileable
Form	MA-742	Owner's Contract of Commitment	form_ma742.pdf	Yes	Yes	Fillable Fileable
Form	MA-828	Vessel Data	form_ma828.pdf	Yes	Yes	Fillable Fileable
Form	MA-942	Interim Binder of Insurance	form_ma942.pdf	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title: War Risk Insurance	FR Citation: 72 FR 34739

Number of Respondents: 45	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 1 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45	-1,386	1,431
Annual IC Time Burden (Hours)	576	-192	768
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supplementary Statement	2133 0011 Supporting Statement.doc	09/17/2007

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