Small Insurers Insurer Group Affliations

Collection of Data from Property and Casualty Insurers for Reports Concerning the Terrorism Risk Insurance Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0257 can be found here:

Documents and Forms

Document Name Document Type
2019 Data Call Instructions Small Insurers (to OMB).docx www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx Instruction
1505-0257 Instructions for Places of Worship Template 2020-03-02.docx home.treasury.gov/policy-issues/financial-markets-financial-institutions-and-fiscal-service/federal-insurance-office/ter Instruction
TBD Terrorism Risk Insurance Program: Small Insurers 2019 Data Call Small Insurers (to OMB).xlsx www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx Form
TBD Terrorism Risk Insurance Program: Places of Worship 1505-0257 2020 Data Call (Places of Worship Template) (Draft).xlsx home.treasury.gov/policy-issues/financial-markets-financial-institutions-and-fiscal-service/federal-insurance-office/ter Form

Information Collection (IC) Details

IC Title:	Small Insurers Insurer Group Affliations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 31 CFR 50.51

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2019 Data Call Instructions Small Insurers (to OMB).docx	https://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx	Yes	Yes	Fillable Fileable
Form	TBD	Terrorism Risk Insurance Program: Small Insurers	2019 Data Call Small Insurers (to OMB).xlsx	https://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx	Yes	Yes	Fillable Fileable
Form	TBD	Terrorism Risk Insurance Program: Places of Worship	1505-0257 2020 Data Call (Places of Worship Template) (Draft).xlsx	https://home.treasury.gov/policy-issues/financial-markets-financial-institutions-and-fiscal-service/federal-insurance-office/terrorism-risk-insurance-program/annual-data-collection	Yes	Yes	Fillable Fileable
Instruction			1505-0257 Instructions for Places of Worship Template 2020-03-02.docx	https://home.treasury.gov/policy-issues/financial-markets-financial-institutions-and-fiscal-service/federal-insurance-office/terrorism-risk-insurance-program/annual-data-collection	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: Data Collection and Comments in Aid of Analyses of the Terrorism Risk Insurance Program	FR Citation: 81 FR 95310

Number of Respondents: 200	Number of Respondents for Small Entity: 200

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	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	5,600	-900	6,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.