Information Collection Request

Notice of Insolvency (29 CFR Part 4245)

ICR 201811-1212-003 · OMB 1212-0033 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 001 Notice of Insolvency (29 CFR Part 4245) Form Modified Available
multi ss 0033 part 4245 supporting statement rollover.docx Supporting Statement A Uploaded 2018-11-14 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13555 Notice of Insolvency (29 CFR Part 4245) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2021 36 Months From Approved 11/30/2018
2,598 0 2,598
20 0 1
12,000 0 723





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Notice of Insolvency (29 CFR Part 4245) 002, 001 Notice of Insolvency Benefit Level ,   Notice of Insolvency

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 2,598 2,598 0 0 0 0
Annual Time Burden (Hours) 20 1 0 0 19 0
Annual Cost Burden (Dollars) 12,000 723 0 0 11,277 0


Reginfo record details
  No