Information Collection Request

Notification of Changes of Insured Status

ICR 201804-3064-011 · OMB 3064-0124 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
FR2-0109 Notification of Change in Insured Status 83 FR 32290 July 12 2018.pdf Supplementary Document Uploaded 2018-07-12 Available
FR1-0124 Notification of Change of Insured Status 83 FR 19284 May 2 2018.pdf Supplementary Document Uploaded 2018-07-12 Available
SPST-0124 Notification of Changes in Insured Status 2018 Renewal FINAL.doc Supporting Statement A Uploaded 2018-07-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
42569 Notification of Changes of Insured Status Modified
232163 Certification New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2021 36 Months From Approved 09/30/2018
152 0 291
40 0 77
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Notification of Changes of Insured Status
Certification

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 152 291 0 0 -139 0
Annual Time Burden (Hours) 40 77 0 0 -37 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No