Information Collection Request

Information Comparision with Insurance Data

ICR 202010-0970-006 · OMB 0970-0342 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 OCSE Insurance Match Standard Input File Record Form and Instruction Modified Available
Form 1 OCSE Insurance Match Standard Input File Record Form and Instruction Modified Repair queued
Form 1 OCSE Insurance Match Standard Input File Record Form and Instruction Modified Available
0970-0342_Insurance Match_Supporting_Statement.docx Supporting Statement A Uploaded 2020-10-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228579 Insurance Match File: Daily Reporting Manually Other-Daily Reporting Manual Submission Modified
228578 Insurance Match File: Daily Reporting Electronically Form and Instruction ModifiedOCSE Insurance Match Standard Input File Record
228577 Insurance Match File: Weekly Reporting Electronically Form and Instruction ModifiedOCSE Insurance Match Standard Input File Record
228576 Insurance Match File: Monthly Reporting Electronically Form and Instruction ModifiedOCSE Insurance Match Standard Input File Record

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2024 36 Months From Approved 01/31/2021
28,390 0 21,210
2,818 0 2,102
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Insurance Match File: Daily Reporting Electronically 1
Insurance Match File: Daily Reporting Manually
Insurance Match File: Monthly Reporting Electronically 1
Insurance Match File: Weekly Reporting Electronically 1

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 28,390 21,210 0 7,180 0 0
Annual Time Burden (Hours) 2,818 2,102 0 716 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No