Information Collection

Schedule of Excess Risks

IC 15363 under ICR 200805-1510-002 · OMB 1510-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1510-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FMS-285-A Schedule of Excess Risks	Form and Instruction
FMS-285-A Schedule of Excess Risks Copy of ser-sample-i (1510-0004).xls www.fms.treas.gov/c570/forms/ser-sample-i.xls	Form and Instruction

IC Title:

Schedule of Excess Risks

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR 223.14

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	FMS-285-A	Schedule of Excess Risks	Copy of ser-sample-i (1510-0004).xls	http://www.fms.treas.gov/c570/forms/ser-sample-i.xls	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 283

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,132	66	1,066
Annual IC Time Burden (Hours)	5,600	-180	5,780
Annual IC Cost Burden (Dollars)	0	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.