Information Collection

Notification of Changes of Insured Status

IC 42569 under ICR 200810-3064-001 · OMB 3064-0124.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0124 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ESS SPST0124 12-30-08 Final.DOC Supporting Statement	IC Document
ESS FR2 0124 12-30-08.doc Federal Register Notice	IC Document

IC Title:

Notification of Changes of Insured Status

Agency IC Tracking Number:

3064-0124

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 307

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

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: Notification of Changes of Insured Status

FR Citation: 73 FR 62499

Number of Respondents: 285

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	Previously Approved
Annual Number of Responses for this IC	285	285
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	ESS SPST0124 12-30-08 Final.DOC	12/30/2008
Federal Register Notice	ESS FR2 0124 12-30-08.doc	12/30/2008

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