Designation of Exempt Person

Forms and Documents

Document Name	Status
Form 110 Designation of Exempt Person Form	Unchanged
DOEP1506-0012(2010-1)_83I_Supp[1].doc Supporting Statement A	2011-01-28
FinCEN Change Justification.docx Justification for No Material/Nonsubstantive Change	2010-09-14

IC Document Collections

IC ID	Document Title	Status
15300	Designation of Exempt Person Form	Unchanged

ICR Details

OMB Control No: 1506-0012	ICR Reference No: 201101-1506-001
Status: Historical Active	Previous ICR Reference No: 201008-1506-005
Agency/Subagency: TREAS/FINCEN	Agency Tracking No:
Title: Designation of Exempt Person
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/28/2011
	Date Received in OIRA: 01/28/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2011	06/30/2011	06/30/2011
Responses	64,999	0	64,999
Time Burden (Hours)	97,499	0	97,499
Cost Burden (Dollars)	0	0	0

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Abstract: This final rule modifies the way Banks will use the form to exempt certain customers from the requirement to report to the Treasury a customer's cash transactions exceeding $10,000. This action updates this ICR to reflect the addition of 31 CFR 103.27(a)(3), 31 CFR 103.27(d), as being renewed as part of this control number. The two additional references constitute two hours to the existing burden. This action is the result of the reallocation of burden from 1506-0009 to 1506-0012

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Authorizing Statute(s): US Code: 31 USC 5311-5332 Name of Law: Bank Secrecy Act
  

Citations for New Statutory Requirements: US Code: 31 USC 5311-5332 Name of Law: Bank Secrecy Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1506-AA90	Final or interim final rulemaking	73 FR 74010	12/05/2008

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 5628	01/30/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Designation of Exempt Person	110	Designation of Exempt Person

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	64,999	64,999	0	0	0	0
Annual Time Burden (Hours)	97,499	97,499	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This NPRM, if approved, reduces the number of information collection items on the form that depository institutions must complete to exempt a eligible customer from CTR filings.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/28/2011

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