Customer Complaint Form

Forms and Documents

Document Name	Status
Customer Complaint Form Form and Instruction	Modified
1557-0232.doc Supporting Statement A	2009-02-05
Justification.doc Justification for No Material/Nonsubstantive Change	2009-01-05
FAX.TIF Supplementary Document	2009-01-05

IC Document Collections

IC ID	Document Title	Status
20142	Customer Complaint Form Form and Instruction	Modified

ICR Details

OMB Control No: 1557-0232	ICR Reference No: 200901-1557-001
Status: Historical Active	Previous ICR Reference No: 200809-1557-002
Agency/Subagency: TREAS/OCC	Agency Tracking No:
Title: Customer Complaint Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/07/2009
	Date Received in OIRA: 01/07/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2011	12/31/2011	12/31/2011
Responses	22,000	0	14,000
Time Burden (Hours)	1,833	0	925
Cost Burden (Dollars)	0	0	0

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Abstract: The Customer Complaint Form was developed as a courtesy for those that contact the OCC's Customer Assistance Group and wish to file a formal, written complaint. This submission makes no change to the purpose of the form. It modifies the form only to simplify and clarify the content and provide the option to submit electronically.

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Authorizing Statute(s): US Code: 15 USC 57a(f)(1) Name of Law: Federal Trade Commission Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 51701	09/04/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 66689	11/10/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Customer Complaint Form	N/A	Customer Complaint Form

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ICR Summary of Burden

	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	22,000	14,000	0	8,000	0	0
Annual Time Burden (Hours)	1,833	925	0	908	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: We implemented a new procedure which resulted in more consumers receiving the form. In addition, we launched a website to assist customers of national banks and other financial institutions with questions common to all banking customers and to provide an additional link to the form.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/07/2009

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