Information Collection Request

Notification of Changes of Insured Status

ICR 201112-3064-001 · OMB 3064-0124 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
SPST 0124 (2012 renewal).DOC Supporting Statement A Uploaded 2012-02-01 Available
2012 30 day 77 FR 4817.pdf Supplementary Document Uploaded 2012-01-31 Available
2011 60 day 76 FR 70447.pdf Supplementary Document Uploaded 2012-01-25 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
42569 Notification of Changes of Insured Status Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2015 36 Months From Approved 04/30/2012
291 0 285
77 0 75
0 0 0





Reginfo record details
1
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IC Title Form No. Form Name
Notification of Changes of Insured Status

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 291 285 0 0 6 0
Annual Time Burden (Hours) 77 75 0 0 2 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No