MONTHLY SAMPLE (FEDERAL) MONTHLY SAMPLE (STATE)

ICR 197704-3133-001

OMB: 3133-0001

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
176120 Migrated
ICR Details
3133-0001 197704-3133-001
Historical Active 197702-3133-001
NCUA
MONTHLY SAMPLE (FEDERAL) MONTHLY SAMPLE (STATE)
No material or nonsubstantive change to a currently approved collection   No
Emergency 04/15/1977
Approved with change 04/15/1977
Retrieve Notice of Action (NOA) 04/15/1977
  Inventory as of this Action Requested Previously Approved
07/31/1977 07/31/1977 07/31/1977
12,000 0 14,400
2,000 0 2,400
0 0 0



None
None


No

1
IC Title Form No. Form Name
MONTHLY SAMPLE (FEDERAL) MONTHLY SAMPLE (STATE) NCUA 5301, NCUA 5303

  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 12,000 14,400 0 0 -2,400 0
Annual Time Burden (Hours) 2,000 2,400 0 0 -400 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/15/1977


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