Terrorism Risk Insurance Program Loss Reporting

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form TRIP 02C Schedule C Bordereau	Form	Modified	Available
Form TRIP 02B Schedule B	Form and Instruction	Modified	Available
Form TRIP 02A Schedule A	Form and Instruction	Modified	Available
Form TRIP 02 Certification of Loss	Form and Instruction	Modified	Available
Form TRIP 01 Initial Notice of Insured Loss	Form and Instruction	Modified	Available
PRA Claims Forms 2010.doc	Supporting Statement A	Uploaded 2010-11-30	Available
Schedule C Instructions 19Nov2010.doc	Supplementary Document	Uploaded 2010-11-19	Available
Schedule C 28Sept2010.xls	Supplementary Document	Uploaded 2010-11-19	Available
Schedule B Revised 19Nov2010.doc	Supplementary Document	Uploaded 2010-11-19	Available
Schedule A Revised 19Nov2010.doc	Supplementary Document	Uploaded 2010-11-19	Available
Certification of Loss Revised 19Nov2010.doc	Supplementary Document	Uploaded 2010-11-19	Available
Initial Notice of Loss Revised 19Nov2010.doc	Supplementary Document	Uploaded 2010-11-19	Available
Fed Reg-claims 2010 update.pdf	Supplementary Document	Uploaded 2010-09-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
39047	Terrorism Risk Insurance Program Loss Reporting	Instruction	Modified
39047	Terrorism Risk Insurance Program Loss Reporting	Form	Modified	Schedule C Bordereau
39047	Terrorism Risk Insurance Program Loss Reporting	Form and Instruction	Modified	Schedule B
39047	Terrorism Risk Insurance Program Loss Reporting	Form and Instruction	Modified	Schedule A
39047	Terrorism Risk Insurance Program Loss Reporting	Form and Instruction	Modified	Certification of Loss
39047	Terrorism Risk Insurance Program Loss Reporting	Form and Instruction	Modified	Initial Notice of Insured Loss

ICR Details

OMB Control No: 1505-0200	ICR Reference No: 201009-1505-001
Status: Historical Active	Previous ICR Reference No: 200801-1505-002
Agency/Subagency: TREAS/DO	Agency Tracking No:
Title: Terrorism Risk Insurance Program Loss Reporting
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/27/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/30/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2014	36 Months From Approved	02/28/2011
Responses	100	0	100
Time Burden (Hours)	4,200	0	4,200
Cost Burden (Dollars)	1,100,000	0	1,100,000

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Abstract: Information collection made necessary by the Terrorism Risk Insurance Act of 2002, as amended by the Terrorism Risk Insurance Extension Act of 2005, the Terrorism Risk Insurance Program Reauthorization Act of 2007, and by Treasury implementing regulations to pay Federal share to commercial property and casualty insurers for terrorism losses.

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Authorizing Statute(s): PL: Pub.L. 109 - 144 103 and 104 Name of Law: Terrorism Risk Insurance Extension Act of 2005
   PL: Pub.L. 110 - 160 104 and 104 Name of Law: Terrorism Risk Insurance Program Reauthorization Act of 2007
   PL: Pub.L. 107 - 297 103 and 104 Name of Law: Terrorism Risk Insurance Act of 2002
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 185	09/24/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 82145	12/29/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Terrorism Risk Insurance Program Loss Reporting	TRIP 01, TRIP 02B, TRIP 02C, TRIP 02A, TRIP 02	Initial Notice of Insured Loss ,   Certification of Loss ,   Schedule A ,   Schedule B ,   Schedule C Bordereau

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ICR Summary of Burden

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	100	100	0	0	0	0
Annual Time Burden (Hours)	4,200	4,200	0	0	0	0
Annual Cost Burden (Dollars)	1,100,000	1,100,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/30/2010

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