Information Collection

Commercial Property and Casualty Insurers Submission for Federal Share of Compensation

IC 39047 under ICR 201706-1505-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form TRIP 01 Commercial Property and Casualty Insurers Submission for Federal Share of Compensation Form and Instruction
TRIP Form 02C Schedule C Instructions.doc tripclaims.treas.gov/TRIP/ Instruction
TRIP Form 02A Schedule A Instructions.doc tripclaims.treas.gov/TRIP/ Instruction
TRIP 01 Notice of Deductible Erosion TRIP Form 01 Notice of Deductible Erosion Treasury Form.doc tripclaims.treas.gov/TRIP/ Form and Instruction
TRIP 02 Certification of Loss TRIP Form 02 Certification of Loss.doc tripclaims.treas.gov/TRIP/ Form and Instruction
TRIP 02A Schedule A TRIP Form 02A Schedule A.doc tripclaims.treas.gov/TRIP/ Form
TRIP 02B Schedule B TRIP Form 02B Schedule B.doc tripclaims.treas.gov/TRIP/ Form and Instruction
TRIP 02C Schedule C Bordereau TRIP Form 02C Schedule C.xls tripclaims.treas.gov/TRIP/ Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Commercial Property and Casualty Insurers Submission for Federal Share of Compensation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR 50

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TRIP 01	Notice of Deductible Erosion	TRIP Form 01 Notice of Deductible Erosion Treasury Form.doc	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02	Certification of Loss	TRIP Form 02 Certification of Loss.doc	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Form	TRIP 02A	Schedule A	TRIP Form 02A Schedule A.doc	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Form and Instruction	TRIP 02B	Schedule B	TRIP Form 02B Schedule B.doc	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Form	TRIP 02C	Schedule C Bordereau	TRIP Form 02C Schedule C.xls	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Instruction			TRIP Form 02C Schedule C Instructions.doc	https://tripclaims.treas.gov/TRIP/	Yes	Yes	Fillable Fileable
Instruction			TRIP Form 02A Schedule A Instructions.doc	https://tripclaims.treas.gov/TRIP/	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: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	4,200	4,200
Annual IC Cost Burden (Dollars)	1,100,000	1,100,000

Documents for IC

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.