Information Collection

?_ B.12 - Premium Capture Reserve Account Disclosures

IC 197604 under ICR 201104-3235-023 · OMB 3235-0684.

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Information Collection (IC) Details

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IC Title:	§_ B.12 - Premium Capture Reserve Account Disclosures	Agency IC Tracking Number:	CF 270-639

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 246

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	1,575	1,575

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