Information Collection

Insurance Surveys

IC 191786 under ICR 201008-2900-005 · OMB 2900-0771.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0771 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Waiver Survey.DOC	Other-survey
CashSurr 292 .doc	Other-survey
Correspondence 292 .doc	Other-Survey
Death Claims Survey.DOC	Other-Survey
IVR 292.doc	Other-Survey
Missing Check Survey.DOC	Other-Survey
PolicyLoanSurvey.doc	Other-Survey
Telephone Survey PSD.doc	Other-Survey
Telephone Survey ICD .doc	Other-Survey
VMLI Survey.doc	Other-Survey
BO Survey .DOC	Other-Survey
SDVI Appllication Survey.DOC	Other-Survey

IC Title:

Insurance Surveys

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-survey	Waiver Survey.DOC	No	Paper Only
Other-survey	CashSurr 292 .doc	No	Paper Only
Other-Survey	Correspondence 292 .doc	No	Paper Only
Other-Survey	Death Claims Survey.DOC	No	Paper Only
Other-Survey	IVR 292.doc	No	Paper Only
Other-Survey	Missing Check Survey.DOC	No	Paper Only
Other-Survey	PolicyLoanSurvey.doc	No	Paper Only
Other-Survey	Telephone Survey PSD.doc	No	Paper Only
Other-Survey	Telephone Survey ICD .doc	No	Paper Only
Other-Survey	VMLI Survey.doc	No	Paper Only
Other-Survey	BO Survey .DOC	No	Paper Only
Other-Survey	SDVI Appllication Survey.DOC	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 480

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	480	480
Annual IC Time Burden (Hours)	48	48
Annual IC Cost Burden (Dollars)	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.