Information Collection

PTE 90-1; Insurance Company Pooled Separate Accounts

IC 43796 under ICR 202112-1210-002 · OMB 1210-0083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0083 can be found here:

Documents and Forms

Document Name Document Type
Final PTE 90-1.pdf Other-PTE 90-1
Final PTE 90-1.pdf Other-PTE 90-1

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PTE 90-1; Insurance Company Pooled Separate Accounts	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PTE 90-1			Final PTE 90-1.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 108	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,080	60	1,020
Annual IC Time Burden (Hours)	180	10	170
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.