Information Collection

Application for Non-Profit Budget and Credit Counseling Agencies

IC 11781 under ICR 200906-1105-002 · OMB 1105-0084.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0084 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form xxxx Application for Non-Profit Budget and Credit Counseling Agencies	Form
CC_Application_Instructions.pdf	Instruction
xxxx Credit Counseling Application CC_Application.pdf	Form
xxxx CC Application Appendix A CC_Application_Appendix_A.pdf	Form
xxxx CC Application B CC_Application_Appendix_B.pdf	Form
xxxx CC Appllication C CC_Application_Appendix_C.pdf	Form
xxxx CC Application Appendix d CC_Application_Appendix_D.pdf	Form
xxxx CC Application Appendix E CC_Application_Appendix_E.pdf	Form
83I OMB.pdf OMB 83-I	IC Document

IC Title:

Application for Non-Profit Budget and Credit Counseling Agencies

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	xxxx	Credit Counseling Application	CC_Application.pdf	Yes	No	Fillable Printable
Form	xxxx	CC Application Appendix A	CC_Application_Appendix_A.pdf	Yes	No	Fillable Printable
Form	xxxx	CC Application B	CC_Application_Appendix_B.pdf	Yes	No	Fillable Printable
Form	xxxx	CC Appllication C	CC_Application_Appendix_C.pdf	Yes	No	Fillable Printable
Form	xxxx	CC Application Appendix d	CC_Application_Appendix_D.pdf	Yes	No	Fillable Printable
Form	xxxx	CC Application Appendix E	CC_Application_Appendix_E.pdf	Yes	No	Fillable Printable
Instruction			CC_Application_Instructions.pdf	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	300	-500	800
Annual IC Time Burden (Hours)	3,000	-5,000	8,000
Annual IC Cost Burden (Dollars)	150,000	150,000	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB 83-I	83I OMB.pdf	06/18/2009

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