2017 Proposed Amended Claims and Related Forms

82 Federal Register 13543 seeking comments on proposed amended claims and related forms is available here –> link.

Treasury Form TRIP 01 (Notice of Deductible Erosion) is available here –> link.

Treasury Form TRIP 02 (Certification of Loss) is available here –> link.

Treasury Form TRIP 02A Schedule A (Direct Earned Premium and Deductible) is available here –> link.

Treasury Form TRIP 02B Schedule B (Compliance Certification) is available here –> link.

Treasury Form TRIP 02B Schedule C (Bordereau) – Form is available here –> link.

Treasury Form TRIP 02B Schedule C (Bordereau) – Instructions is available here –> link.

Treasury Form TRIP 03 (Notice of Proposed Settlement of Third Party Claim Request for Approval) is available here –> link.

Treasury Form TRIP 04A (Direct Written Premium and Monthly Surcharge Calculation) – Form is available here –> link.

Treasury Form TRIP 04A (Direct Written Premium and Monthly Surcharge Calculation) – Instructions is available here –> link.

Treasury Form TRIP 04B (Direct Written Premium and End of Year Surcharge Calculation) – Form is available here –> link.

Treasury Form TRIP 04B (Direct Written Premium and End of Year Surcharge Calculation) – Instructions is available here –> link.

Treasury Form TRIP 05 (Data Call) – Form is available here –> link.

Treasury Form TRIP 05 (Data Call) – Instructions is available here –> link.

Treasury Form TRIP 06 (Certification Data Call) – Form is available here –> link.

Treasury Form TRIP 06 (Certification Data Call) – Instructions is available here –> link.

Treasury Form TRIP 07 (Monthly Claims Report) – Form is available here –> link.

Treasury Form TRIP 07 (Monthly Claims Report) – Instructions is available here –> link.

2017 US Treasury Data Call Templates

Alien Surplus Lines Insurers

The 2017 US Treasury Data Collection Template is available here –> link.

The 2017 US Treasury Data Collection Data Dictionary is available here –> link.

Captive Insurers

The 2017 US Treasury Data Collection Template is available here –> link.

The 2017 US Treasury Data Collection Data Dictionary is available here –> link.

Insurer (non-small) Groups or Companies 

The 2017 US Treasury Data Collection Template is available here –> link.

The 2017 US Treasury Data Collection Data Dictionary is available here –> link.

Small Insurers

The 2017 US Treasury Data Collection Template is available here –> link.

The 2017 US Treasury Data Collection Data Dictionary is available here –> link.

Insurers are asked to provide Calendar Year 2016 data on a Group basis (including all affiliate companies) by May 15, 2017.

The portal instructions are available here –> link.

The portal registration form is available here –> link.

A summary of insurer definitions is available here –> link.

The submission to OMB is available here — link.