Information Collection

Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More

IC 46036 under ICR 201011-1545-018 · OMB 1545-0128.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Schedule M-3 (Form Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More	Form
2009 M-3 inst..pdf	Instruction
Schedule M-3 (Form Net Income (Loss) Reconciliation for Life Insurance Comp 2010 M-3 draft.pdf	Form
2010 M-3 burden.PDF Burden Computation for Sch M-3 (Form 1120-L)	IC Document

IC Title:

Agency IC Tracking Number:

ah-0128-028

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Schedule M-3 (Form 1120-L)	Net Income (Loss) Reconciliation for Life Insurance Companies with Total Assets of $10 Million or More	2010 M-3 draft.pdf		Yes	Yes	Fillable Fileable
Instruction			2009 M-3 inst..pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	182,660	182,660
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden Computation for Sch M-3 (Form 1120-L)	2010 M-3 burden.PDF	11/17/2010

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