Notice of Issuance of Insurance Policy

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Notice of Issuance of Insurance Policy	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 726.206 20 CFR 726.208 -.213

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,465	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	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,465	-35	3,500
Annual IC Time Burden (Hours)	61	3	58
Annual IC Cost Burden (Dollars)	9	9	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.