Information Collection

Captive Insurers Reinsurance (Nationwide)

IC 225988 under ICR 202009-1505-002 · OMB 1505-0257.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2019 Data Call Instructions Captive 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: Captive Insurers 2019 Data Call Captive Insurers (to OMB).xlsx www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx	Form
TBD Terorism 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

IC Title:

Captive Insurers Reinsurance (Nationwide)

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2019 Data Call Instructions Captive 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: Captive Insurers	2019 Data Call Captive Insurers (to OMB).xlsx	https://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx	Yes	Yes	Fillable Fileable
Form	TBD	Terorism 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: 550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	550	0	550
Annual IC Time Burden (Hours)	28,050	50	28,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.