Information Collection

Self-test disclosures setup/monitoring

IC 188254 under ICR 200903-3084-002 · OMB 3084-0087.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3084-0087 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Self-test disclosures setup/monitoring	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 202

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 40 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,500	2,500
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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