Information Collection

Report of Premiums Payable for Financial Institutions Only

IC 45939 under ICR 201011-3048-002 · OMB 3048-0021.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3048-0021 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EIB 92-30 Report of Premiums Payable for Financial Institutions Only	Form
EIB 92-30 Report of Premums for Financial Institutions Only new_EIB_92-30 final.pdf	Form

IC Title:

Report of Premiums Payable for Financial Institutions Only

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	EIB 92-30	Report of Premums for Financial Institutions Only	new_EIB_92-30 final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,800	0	1,800
Annual IC Time Burden (Hours)	1,200	750	450
Annual IC Cost Burden (Dollars)	0	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.