Terrorism Risk Insurance Program Loss Reporting

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0200 can be found here:

Documents and Forms

Document Name Document Type
Form TRIP 01 Terrorism Risk Insurance Program Loss Reporting Form and Instruction
Schedule C Instructions 19Nov2010.doc Instruction
TRIP 01 Initial Notice of Insured Loss Initial Notice of Loss Revised 19Nov2010.doc Form and Instruction
TRIP 02 Certification of Loss Certification of Loss Revised 19Nov2010.doc Form and Instruction
TRIP 02A Schedule A Schedule A Revised 19Nov2010.doc Form and Instruction
TRIP 02B Schedule B Schedule B Revised 19Nov2010.doc Form and Instruction
TRIP 02C Schedule C Bordereau Schedule C 28Sept2010.xls Form
Initial Notice of Loss Revised 19Nov2010.doc Initial Notice of Insured Loss IC Document
Certification of Loss Revised 19Nov2010.doc Certification of Loss IC Document
Schedule A Revised 19Nov2010.doc Schedule A IC Document
Schedule B Revised 19Nov2010.doc Schedule B IC Document
Schedule C 28Sept2010.xls Schedule C Bordereau IC Document
Schedule C Instructions 19Nov2010.doc Schedule C Instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Terrorism Risk Insurance Program Loss Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TRIP 01	Initial Notice of Insured Loss	Initial Notice of Loss Revised 19Nov2010.doc	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02	Certification of Loss	Certification of Loss Revised 19Nov2010.doc	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02A	Schedule A	Schedule A Revised 19Nov2010.doc	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02B	Schedule B	Schedule B Revised 19Nov2010.doc	Yes	Yes	Fillable Fileable
Form	TRIP 02C	Schedule C Bordereau	Schedule C 28Sept2010.xls	Yes	Yes	Fillable Fileable
Instruction			Schedule C Instructions 19Nov2010.doc	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	4,200	4,200
Annual IC Cost Burden (Dollars)	1,100,000	1,100,000

Documents for IC

Title	Document	Date Uploaded
Initial Notice of Insured Loss	Initial Notice of Loss Revised 19Nov2010.doc	11/19/2010
Certification of Loss	Certification of Loss Revised 19Nov2010.doc	11/19/2010
Schedule A	Schedule A Revised 19Nov2010.doc	11/19/2010
Schedule B	Schedule B Revised 19Nov2010.doc	11/19/2010
Schedule C Bordereau	Schedule C 28Sept2010.xls	11/19/2010
Schedule C Instructions	Schedule C Instructions 19Nov2010.doc	11/19/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.