Notice of Issuance of Insurance Policy

Notice of Issuance of Insurance Policy

OMB: 1240-0048

IC ID: 13700

Information Collection (IC) Details

View Information Collection (IC)

Notice of Issuance of Insurance Policy
 
No Modified
 
Mandatory
 
20 CFR 726.208 -.213 20 CFR 726.206

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CM-921 Notice of Issuance of Insurance Policy CM-921.pdf http://www.dol.gov/owcp/regs/compliance/cm-921.pdf Yes No Printable Only

Income Security Survivor Compensation

 

60 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,800 0 0 -200 0 4,000
Annual IC Time Burden (Hours) 633 0 0 -34 0 667
Annual IC Cost Burden (Dollars) 1,975 0 0 95 0 1,880

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