Information Collection

Reports by insurance companies of suspicious transactions

IC 15337 under ICR 202405-1506-010 · OMB 1506-0029.

Documents and Forms

Document Name Document Type
Form FinCEN 111 Reports by insurance companies of suspicious transactions Form and Instruction
FinCEN 111 Suspicious Activity Report FinCEN SAR.pdf bsaefiling.fincen.treas.gov/main.html Form and Instruction
FinCEN 111 Suspicious Activity Report FinCEN SAR.pdf bsaefiling.fincen.treas.gov/main.html Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reports by insurance companies of suspicious transactions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 31 CFR 1025.320

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FinCEN 111	Suspicious Activity Report	FinCEN SAR.pdf	http://bsaefiling.fincen.treas.gov/main.html	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records
Title: FinCEN Privacy Act System of Records Notice	FR Citation: 79 FR 20969

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	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.