Information Collection Request

Payment of Premiums (29 CFR part 4007)

ICR 202012-1212-003 · OMB 1212-0009 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Premium Filing Payment of Premiums (29 CFR part 4007) Form Modified Repair queued
2021 (material) 1212-0009 Supporting Statement.06.docx Supporting Statement A Uploaded 2020-12-23 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13518 Payment of Premiums (29 CFR part 4007) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 12/31/2022
31,245 31,245
13,540 13,540
21,621,540 21,621,540





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Payment of Premiums (29 CFR part 4007) Premium Filing Premium Filing Screen Shots

table that charts list of burden
  Total Request 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 31,245 31,245 0 0 0 0
Annual Time Burden (Hours) 13,540 13,540 0 0 0 0
Annual Cost Burden (Dollars) 21,621,540 21,621,540 0 0 0 0


Reginfo record details
  No