Information Collection

Statement of Purpose for an Extension of Credit by a Creditor

IC 35993 under ICR 201010-7100-005 · OMB 7100-0019.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 7100-0019 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FR T-4 Statement of Purpose for an Extension of Credit by a Creditor	Form and Instruction
FR T-4 Statement of Purpose for an Extension of Credit by a Cre FR_T-4_20110113_f_i.pdf www.federalreserve.gov/reportforms/default.cfm	Form and Instruction

IC Title:

Statement of Purpose for an Extension of Credit by a Creditor

Agency IC Tracking Number:

FR T-4

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	FR T-4	Statement of Purpose for an Extension of Credit by a Creditor	FR_T-4_20110113_f_i.pdf	http://www.federalreserve.gov/reportforms/default.cfm	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 135

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	Previously Approved
Annual Number of Responses for this IC	2,700	2,700
Annual IC Time Burden (Hours)	459	459
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.