Information Collection Request

Notice of Insolvency (29 CFR Part 4245)

ICR 202205-1212-006 · OMB 1212-0033 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 001 Notice of Insolvency (29 CFR Part 4245) Form Modified Repair queued
Supporting statement part 4245v.05.docx Supporting Statement A Uploaded 2022-05-17 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13555 Notice of Insolvency (29 CFR Part 4245) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 06/30/2022
1,038 1,038
16 16
10,000 10,000





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Notice of Insolvency (29 CFR Part 4245) 002, 001, 003 Notice of Insolvency Benefit Level ,   Notice of Insolvency ,   Combined Notice of Insolvency and Notice of Insolvency Benefit Level

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 1,038 1,038 0 0 0 0
Annual Time Burden (Hours) 16 16 0 0 0 0
Annual Cost Burden (Dollars) 10,000 10,000 0 0 0 0


Reginfo record details
  No