Information Collection

Interagency Notice of Change in Director or Executive Officer

IC 31859 under ICR 200903-3064-005 · OMB 3064-0097.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0097 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3064-0097 Interagency Notice of Change in Director or Executive Officer	Form and Instruction
3064-0097 Interagency Notice of Change in Director or Senior Execu ESS 0097 Form 4-21-09.pdf www.fdic.gov/formsdocuments/interag1.pdf	Form and Instruction
ESS First FR Notice 0097 2.13.09.pdf First Federal Register Notice	IC Document
ESS Second FR Notice 0097. 4-21-09.pdf Second Federal Register Notice	IC Document

IC Title:

Interagency Notice of Change in Director or Executive Officer

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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 and Instruction	3064-0097	Interagency Notice of Change in Director or Senior Executive Officer	ESS 0097 Form 4-21-09.pdf	http://www.fdic.gov/formsdocuments/interag1.pdf	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	Previously Approved
Annual Number of Responses for this IC	400	200	200
Annual IC Time Burden (Hours)	800	400	400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
First Federal Register Notice	ESS First FR Notice 0097 2.13.09.pdf	04/21/2009
Second Federal Register Notice	ESS Second FR Notice 0097. 4-21-09.pdf	04/21/2009

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