Survey of Nonparticipating Single-Premium Group Annuity Rates

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0030 can be found here:

Documents and Forms

Document Name Document Type
ACLI SURVEY to OMB 2015.doc Instruction
Supporting Statement Part A 2015 Final.docx Supporting Statement Part A IC Document
Supporting Statement Part B 2015 Final.docx Supporting Statement Part B IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey of Nonparticipating Single-Premium Group Annuity Rates	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			ACLI SURVEY to OMB 2015.doc		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	24	0	24
Annual IC Time Burden (Hours)	12	0	12
Annual IC Cost Burden (Dollars)	0	-360	360

Documents for IC

Title	Document	Date Uploaded
Supporting Statement Part A	Supporting Statement Part A 2015 Final.docx	03/09/2015
Supporting Statement Part B	Supporting Statement Part B 2015 Final.docx	03/09/2015

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