Information Collection

Application for Ordinary, Life Insurance and Information about Modified Life Reduction

IC 28405 under ICR 200108-2900-002 · OMB 2900-0166.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0166 can be found here:

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Information Collection (IC) Details

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IC Title:	Application for Ordinary, Life Insurance and Information about Modified Life Reduction	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	2900-8700	No	No
Form	29-8701	No	No
Form	29-8485A	No	No
Form	2900-8700A-E	No	No
Form	29-8485	No	No
Form	29-8701A-E	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.