Standard Reinsurance Agreement

Standard Reinsurance Agreement Plan of Operations

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0563-0069 can be found here:

Documents and Forms

Document Name Document Type
Standard Reinsurance Agreement Form
Business Pandemic Influenza Checklist business-pandemic-influenza.pdf Form
Commercial Fund Template CommericalFundTemplate.pdf Form
Escrow Agreement with Bank EscrowAgreementwBank.pdf Form
Escrow Agreement with Reinsured Company EscrowAgreementwReinsuredCompany.pdf Form
Total Expense TotalExpense.pdf Form
Loss Adjustment Expense Template LossAdjustmentExpenseTemplate.pdf Form
Agent Comp Template AgentCompTemplate.pdf Form
Estimated Premium Template EstimatedPremiumTemplate.pdf Form

Information Collection (IC) Details

IC Title:	Standard Reinsurance Agreement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 1508 (k)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	N/A	Business Pandemic Influenza Checklist	business-pandemic-influenza.pdf	No	Paper Only
Form	N/A	Escrow Agreement with Bank	EscrowAgreementwBank.pdf	No	Paper Only
Form	N/A	Escrow Agreement with Reinsured Company	EscrowAgreementwReinsuredCompany.pdf	No	Paper Only
Form	N/A	Total Expense	TotalExpense.pdf	No	Paper Only
Form	N/A	Agent Comp Template	AgentCompTemplate.pdf	No	Paper Only
Form	N/A	Estimated Premium Template	EstimatedPremiumTemplate.pdf	No	Paper Only
Form	N/A	Commercial Fund Template	CommericalFundTemplate.pdf	No	Paper Only
Form	N/A	Loss Adjustment Expense Template	LossAdjustmentExpenseTemplate.pdf	No	Paper Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 21,016	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	70,252	15,016	14,960	40,276
Annual IC Time Burden (Hours)	175,684	15,384	16,036	144,264
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.