U.S. Life Insurance Company Income Tax Return

Forms and Documents

Document Name	Status
Form Schedule M-3 (Form Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More Form	Modified
SS1120L_REV.doc Supporting Statement A	2010-12-13
Expiration Explanation.rtf Supplementary Document	2010-11-17

IC Document Collections

IC ID	Document Title	Status
46036	Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More Form	Modified
39570	U.S. Life Insurance Company Income Tax Return Instruction	Modified

ICR Details

OMB Control No: 1545-0128	ICR Reference No: 201011-1545-018
Status: Historical Active	Previous ICR Reference No: 200901-1545-028
Agency/Subagency: TREAS/IRS	Agency Tracking No: ah-0128-028
Title: U.S. Life Insurance Company Income Tax Return
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/06/2011
	Date Received in OIRA: 12/20/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	03/31/2011
Responses	4,440	0	4,440
Time Burden (Hours)	644,748	0	644,138
Cost Burden (Dollars)	0	0	0

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Abstract: Life Insurance companies are required to file an annual return of income and compute and pay the tax due. The data is used to insure that companies have correctly reported taxable income and paid the correct tax.

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Authorizing Statute(s): US Code: 26 USC 801 Name of Law: Tax imposed.
   PL: Pub.L. 110 - 343 321, 323(a), 324 Name of Law: Tax Extenders and Alternative Minimum Tax Relief Act of 2008
   PL: Pub.L. 110 - 343 302 Name of Law: Emergency Economic Stabilization Act of 2008
   PL: Pub.L. 110 - 289 3022, 3081 Name of Law: Housing and Economic Recovery Act of 2008
   PL: Pub.L. 110 - 246 15316, 15321 Name of Law: Food, Conservation, and Energy Act of 2008
   PL: Pub.L. 110 - 245 303 Name of Law: Heroes Earnings Assistance and Relief Tax Act of 2008
   PL: Pub.L. 109 - 280 1202, 1204 Name of Law: Pension Protection Act of 2006
  

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 49025	08/12/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 79439	12/20/2010
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
U.S. Life Insurance Company Income Tax Return	1120-L	U.S. Life Insurance Company Income Tax return
Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More	Schedule M-3 (Form 1120-L)	Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More

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ICR Summary 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	4,440	4,440	0	0	0	0
Annual Time Burden (Hours)	644,748	644,138	0	610	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: One line was added to ask if the corporation is required to file Schedule UTP with the Form 1120.

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Annual Cost to Federal Government: $20,695

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)? Yes

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: 12/20/2010

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