Information Collection

Terrorism Risk Insurance Program Loss Reporting

IC 39047 under ICR 201309-1505-001 · OMB 1505-0200.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0200 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TRIP 01 Initial Notice of Insured Loss Terrorism Risk Insurance Program Loss Reporting	Form and Instruction
Form TRIP 02 Certification of Loss Terrorism Risk Insurance Program Loss Reporting	Form and Instruction
Form TRIP 02A Schedule A Terrorism Risk Insurance Program Loss Reporting	Form and Instruction
Form TRIP 02B Schedule B Terrorism Risk Insurance Program Loss Reporting	Form and Instruction
Form TRIP 02C Schedule C Bordereau Terrorism Risk Insurance Program Loss Reporting	Form
TRIP Schedule C instructions 9Sept2013.doc	Instruction
TRIP 01 Initial Notice of Insured Loss TRIP INIL 9Sept2013.doc	Form and Instruction
TRIP 02 Certification of Loss TRIP COL 9Sept2013.doc	Form and Instruction
TRIP 02A Schedule A TRIP Schedule A 9Sept2013.doc	Form and Instruction
TRIP 02B Schedule B TRIP Schedule B 9Sept2013.doc	Form and Instruction
TRIP 02C Schedule C Bordereau TRIP Schedule C 9Sept2013.xls	Form

IC Title:

Terrorism Risk Insurance Program Loss Reporting

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.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TRIP 01	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02A	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02B	Yes	Yes	Fillable Fileable
Form	TRIP 02C	Yes	Yes	Fillable Fileable
Instruction		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 98 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	1,900	100
Annual IC Time Burden (Hours)	4,200	0	4,200
Annual IC Cost Burden (Dollars)	1,100,000	0	1,100,000

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.

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