Information Collection Request

Payment of Premiums (29 CFR part 4007)

ICR 202508-1212-004 · OMB 1212-0009 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Premium Filing Premium Filing Screen Shots Form Modified Available
Form Premium Filing Payment of Premiums (29 CFR part 4007) Form Modified Repair queued
1212-0009 Supporting Statement 2025.06.docx Supporting Statement A Uploaded 2025-08-25 Available
1212-0009 Supporting Statement 2025.06.docx Supporting Statement A Uploaded 2025-08-25 Repair queued
Justification of non-material changes Premium Filing 2024.04.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-12-20 Repair queued
Justification of non-material changes Premium Filing 2024.04.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-12-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13518 Payment of Premiums (29 CFR part 4007) Form ModifiedPremium Filing Screen Shots
13518 Payment of Premiums (29 CFR part 4007) Form Modified
13518 Payment of Premiums (29 CFR part 4007) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2028 36 Months From Approved 12/31/2026
29,288 0 31,303
12,691 0 13,565
20,267,296 0 21,661,676





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Payment of Premiums (29 CFR part 4007) Premium Filing

table that charts list of burden
  Total Approved 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 29,288 31,303 0 -2,015 0 0
Annual Time Burden (Hours) 12,691 13,565 0 -874 0 0
Annual Cost Burden (Dollars) 20,267,296 21,661,676 0 -1,394,380 0 0


Reginfo record details
  No