Information Collection Request

Payment of Premiums (29 CFR part 4007)

ICR 201007-1212-001 · OMB 1212-0009 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 2011 Form 1-C; 201 Payment of Premiums (29 CFR part 4007) Form and Instruction Modified Available
Effective Interest Rate_2012_Part III.d1 and Instructions to OMB July 2010.pdf Supplementary Document Uploaded 2010-07-21 Available
Supporting Statement_Premium Filings_to OMB July 2010.pdf Supporting Statement A Uploaded 2010-07-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13518 Payment of Premiums (29 CFR part 4007) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2013 36 Months From Approved 02/28/2011
34,300 0 34,300
9,015 0 8,999
59,960,000 0 47,036,605





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Payment of Premiums (29 CFR part 4007) 2011 Form 1-C; 2011 Form 1-ES 2011 Comprehensive Premium Filing; 2011 Estimated Flat-rate Premium Filing

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 34,300 34,300 0 0 0 0
Annual Time Burden (Hours) 9,015 8,999 0 0 16 0
Annual Cost Burden (Dollars) 59,960,000 47,036,605 0 0 12,923,395 0


Reginfo record details
  No