Information Collection

Insurance Surveys

IC 191786 under ICR 201708-2900-039 · OMB 2900-0771.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0771 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BO Survey.pdf	Other-Customer Survey
SDVI Appllication Survey.pdf	Other-Customer Survey
Death Claims Survey.pdf	Other-Customer Survey
VMLI Survey.pdf	Other-Customer Survey
Waiver Survey.pdf	Other-Customer Survey
Telephone Survey ICD.pdf	Other-Customer Survey
Telephone Survey PSD.pdf	Other-Customer Survey
PolicyLoanSurvey.pdf	Other-Customer Survey
CashSurr 292.pdf	Other-Customer Survey
Correspondence 292.pdf	Other-Customer Survey

IC Title:

Insurance Surveys

Agency IC Tracking Number:

2900-0771 VBA-INS-DB

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Customer Survey	BO Survey.pdf	No	Paper Only
Other-Customer Survey	SDVI Appllication Survey.pdf	No	Paper Only
Other-Customer Survey	Death Claims Survey.pdf	No	Paper Only
Other-Customer Survey	VMLI Survey.pdf	No	Paper Only
Other-Customer Survey	Waiver Survey.pdf	No	Paper Only
Other-Customer Survey	Telephone Survey ICD.pdf	No	Paper Only
Other-Customer Survey	Telephone Survey PSD.pdf	No	Paper Only
Other-Customer Survey	PolicyLoanSurvey.pdf	No	Paper Only
Other-Customer Survey	CashSurr 292.pdf	No	Paper Only
Other-Customer Survey	Correspondence 292.pdf	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	4,440	-1,059	5,499
Annual IC Time Burden (Hours)	444	-106	550
Annual IC Cost Burden (Dollars)	0	0	0

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.