Information Collection

PTE 90-1; Insurance Company Pooled Separate Accounts

IC 43796 under ICR 202410-1210-003 · OMB 1210-0083.

Documents and Forms

Document Name Document Type
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: 46	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 99 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	460	-620	1,080
Annual IC Time Burden (Hours)	77	-103	180
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.