Notice of Claim and Proof of Loss, Export Credit Insurance Policy

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form EIB 10-03 Notice of Claim & Proof of Loss, Export Credit Insurance Policies	Form	Unchanged	Available
Paper Claim Forms 7-7-11 rev2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2011-07-12	Available
EIB 10-03 Supporting Statement.doc	Supporting Statement A	Uploaded 2011-02-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
196186	Notice of Claim & Proof of Loss, Export Credit Insurance Policies	Form	Unchanged

ICR Details

OMB Control No: 3048-0033	ICR Reference No: 201107-3048-002
Status: Historical Active	Previous ICR Reference No: 201102-3048-002
Agency/Subagency: EXIMBANK	Agency Tracking No: EIB 10-03
Title: Notice of Claim and Proof of Loss, Export Credit Insurance Policy
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/28/2011
	Date Received in OIRA: 07/12/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	05/31/2014	05/31/2014
Responses	300	0	300
Time Burden (Hours)	360	0	360
Cost Burden (Dollars)	18,000	0	18,000

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Abstract: Export Import Bank recently determined that it should harmonize and streamline the claim filing forms used by its customers. OMB 3048-0033 EIB 10-03 Notice of Claim and Proof of Loss Export Credit Insurance Policy was just approved by OMB. We discovered that this form was organized differently than OMB 3048-0035 and OMB 0038-0034 making it difficult to use. We have reorganized this form and are requesting OMB to allow us to use it with the clearance granted in May 2011. See attached supplementary documentation.

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Authorizing Statute(s): US Code: 12 USC 635 Name of Law: Export Import Bank of the United States
  

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 220	11/16/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 24	01/31/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Notice of Claim & Proof of Loss, Export Credit Insurance Policies	EIB 10-03	Notice of claim & Proof of Loss, Export Credit Insurance Policies Application

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ICR Summary of Burden

table that charts list 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	300	300	0	0	0	0
Annual Time Burden (Hours)	360	360	0	0	0	0
Annual Cost Burden (Dollars)	18,000	18,000	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is a new form. The Bank is revising all insurance claim forms to provide more effective and efficient filing and processing for our customers.

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Annual Cost to Federal Government: $18,000

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)? No

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: 07/12/2011

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