Information Collection

Disclosures by Insurers to General Account Policyholders

IC 13479 under ICR 201505-1210-003 · OMB 1210-0114.

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Documents and Forms

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IC Title:

Disclosures by Insurers to General Account Policyholders

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2550.401c-1

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 397

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32,000	-64,223	96,223
Annual IC Time Burden (Hours)	135,000	-273,948	408,948
Annual IC Cost Burden (Dollars)	12,000	-21,678	33,678

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.