Information Collection

Certified Statement - Semiannual Assessment Due The Fdic

IC 151549 under ICR 198703-3064-002 · OMB 3064-0057.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

CERTIFIED STATEMENT - SEMIANNUAL ASSESSMENT DUE THE FDIC

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	6420/11	No	No
Form	6420/10	No	No
Form	FDIC 6420/07	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,750

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	29,500	29,500
Annual IC Time Burden (Hours)	14,750	14,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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

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