SRA Grid

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. (D), (F), (H), (I), and (K) should be entered in items 17 & 18 of SF-83. For cols. (E), (G), and (J), the averages of the totals shall be computed, as follows, and then entered on the SF-83. (F) Total = (E) Average (H) Total = (G) Average (K) Total = (J) Average (D) Total (F) Total (I) Total		TITLE OF INFORMATION COLLECTION DOCUMENT Standard Reinsurance Agreement					OMB NO. 0563-0069			PAGE 1 of 2
							DATE PREPARED: 10/27/20
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT		FORM NO(S) (If "none", so state)	ANNUAL BURDEN
SECTION OF REGS	DESCRIPTION		REPORTS					RECORDS
			NO. OF RESPONDENTS	NO. OF RESPONSES PER RESPONDENT	TOTAL ANNUAL RESPONSES (Col. D x E)	HOURS PER RESPONSE	TOTAL HOURS (Col. F x G)	NO. OF RECORDKEEPERS	ANNUAL HOURS OF RECORDKEEPING	TOTAL RECORDKEEPING HOURS (Col.I x J)
(A)	(B)	(C)	(D)	(E )	(F)	(G)	(H)	(I)	(j)	(K)
7 CFR Ch. IV -	APPENDIX I
Subpart L	Conflict of Interest Disclosure
	Section VI(e) - Agents, Adjusters, and Employees		22000	1	22000	1	22000
	Section VI(e) - AIPs		14	1	14	24	336
	Controlled Business Certification
	Section VII(b) - Agents		14000	1	14000	1	14000
	Section VII(b) - AIP Reporting		14	1	14	24	336
	APPENDIX II
	Section I(a)		14	1	14	1	14
	Section I(b)		14	1	14	1	14
	Section I(c)		14	1	14	1	14
	Section II(a)		14	1	14	1	14
	Section II(b)		14	1	14	1	14
	Section II(c)		14	1	14	1	14
	Section II(d)		14	1	14	1	14
	Section II(e)		14	1	14	1	14
	Section II(f)		14	1	14	1	14
	Section II(g)		14	1	14	1	14
	Section II(h)		14	1	14	1	14
	Section III(b)		14	1	14	2	28
	Section III(c)		14	1	14	2	28
	Section III(d)		14	1	14	8	112
	Section III(e)		14	1	14	1	14
	Section III(f)		14	1	14	16	224
	Section III(g)		14	1	14	16	224
	Section III(h)		14	1	14	8	112
	Section III(i)		14	1	14	1	14
	Section IV(a)		14	1	14	1	14
	Section IV(b)		14	1	14	1	14
	Section IV(c)		14	1	14	1	14
	Section IV(d)		14	1	14	1	14
	Section IV(e)		14	1	14	1	14
	Section IV(f)		14	1	14	1	14
	Section IV(g)		14	1	14	1	14
	Section IV(h)		14	1	14	1	14
	Section IV(i)		14	1	14	1	14
	Section IV(j)		14	1	14	1	14
	Section IV(k)		14	1	14	1	14
	Section IV(l)		14	1	14	1	14
	Section IV(m)		14	1	14	4	56
	Section IV(n)		14	1	14	4	56
	Section V(a)		14	1	14	1	14
	Section V(b)		14	1	14	8	112
	Section V(c )		14	1	14	1	14
	Section V(d)		14	1	14	1	14
	Section VI(a)		14	1	14	8	112
	Section VI(b)		14	1	14	12	168
	Section VI(c)		14	1	14	8	112
	Section VI(d)		14	1	14	4	56
	AIP App. II Total					128	1792
	APPENDIX IV
	Section I(a) - QC Plan, App II section VI(j)		14	1	14	20	280
	Section II(a) - TPEP/TEPR, App II section VI(i)		14	1	14	30	420
	Section III(a) - QC report		14	1	14	24	336
	AIP App. IV Total					74	1036
	Section II(d)(1) - Agent training hours		14000	1	14000	4	56000
	Section II(d)(2) - Loss Adjuster training hours		5500	1	5500	17	93500
	Totals				56144		189000