Information Collection

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IC 178451 under ICR 200611-1076-003 · OMB 1076-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0020 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5-4760a default and options	Form
5-4760a Notice of Default 0K5-4760aNOTICEofDEFAULT11.9.pdf	Form
5-4759 Assignment of Loan Documents 0K5-4759ASSIGNMENTofLOANDOCUMENTS&RelatedRights11.9.pdf	Form

IC Title:

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Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 103.35 25 CFR 103.36

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5-4760a	Notice of Default	0K5-4760aNOTICEofDEFAULT11.9.pdf		No		Paper Only
Form	5-4759	Assignment of Loan Documents	0K5-4759ASSIGNMENTofLOANDOCUMENTS&RelatedRights11.9.pdf		No		Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.