Information Collection Request

Information Comparision with Insurance Data

ICR 202311-0970-003 · OMB 0970-0342 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Insurance Match File: Quarterly Reporting Electronically Form and Instruction New Repair queued
Form 1 Insurance Match File: Daily Reporting Electronically Form and Instruction Modified Repair queued
Form 1 Insurance Match File: Weekly Reporting Electronically Form and Instruction Modified Repair queued
Form 1 Insurance Match File: Monthly Reporting Electronically Form and Instruction Modified Repair queued
0970-0342_Insurance Match_Supporting_Statement_102523.docx Supporting Statement A Uploaded 2023-11-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
263231 Insurance Match File: Quarterly Reporting Electronically Form and Instruction New
228579 Insurance Match File: Daily Reporting Manually Other-Daily Reporting Manual Submission Modified
228578 Insurance Match File: Daily Reporting Electronically Form and Instruction Modified
228577 Insurance Match File: Weekly Reporting Electronically Form and Instruction Modified
228576 Insurance Match File: Monthly Reporting Electronically Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2024
31,173 28,390
3,091 2,818
0 0





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 31,173 28,390 0 2,783 0 0
Annual Time Burden (Hours) 3,091 2,818 0 273 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No