Information Collection

Applicant's Voluntary Self-Identification Form

IC 182371 under ICR 201011-7100-007 · OMB 7100-0181.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 7100-0181 can be found here:

Documents and Forms

Document Name Document Type
Form FR 28s Applicant's Voluntary Self-Identification Form Form
FR 28s Applicant's Voluntary Self-Identification Form FR_28s_Self.ID_f.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Applicant's Voluntary Self-Identification Form	Agency IC Tracking Number:	FR 28s

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FR 28s	Applicant's Voluntary Self-Identification Form	FR_28s_Self.ID_f.pdf		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.