Reports by insurance companies of suspicious transactions

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

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 %

	Requested	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.