Information Collection

Consumer Response Intake Form (Web)

IC 198357 under ICR 201106-1505-005 · OMB 1505-0241.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screenshot 1.png	Other-Screen shot
Screenshot 2.png	Other-Screen Shot
Screenshot 3.png	Other-Screen Shot
Screenshot 4 - Mortgage ONLY.png	Other-Screen Shot
Screenshot 4.png	Other-Screen Shot
10.6.11 intake screenshot 1.1.png	Other-Screen Shot
10.6.11 Mortgage intake screenshot 3.png	Other-Screen Shot
10.6.11 Mortgage intake screenshot 5.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 1.2.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 1.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 2.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 4.png	Other-Screen Shot
10.6.11 intake screenshot 1.1.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 1.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 1.2.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 2.png	Other-Screen Shot
Steering Committee Mortgage intake screenshot 4.png	Other-Screen Shot
10.6.11 Mortgage intake screenshot 3.png	Other-Screen Shot
10.6.11 Mortgage intake screenshot 5.png	Other-Screen Shot

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable
Other-Screen Shot	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,250,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	2,250,000	2,250,000
Annual IC Time Burden (Hours)	262,500	262,500
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].