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PTE 90-1; Insurance Company Pooled Separate Accounts
PTE 1990-1; Insurance Company Pooled Separate Accounts
OMB: 1210-0083
IC ID: 43796
OMB.report
DOL/EBSA
OMB 1210-0083
ICR 201808-1210-004
IC 43796
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0083 can be found here:
2022-02-23 - Extension without change of a currently approved collection
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:
Mandatory
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
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
102
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
99 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,020
0
0
60
0
960
Annual IC Time Burden (Hours)
170
0
0
10
0
160
Annual IC Cost Burden (Dollars)
0
0
0
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.