Information Collection

Suspicious Activity Report by Depository Institutions

IC 43829 under ICR 201109-1506-002 · OMB 1506-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1506-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FinCEN Form 111 Suspicious Activity Report by Depository Institutions	Form
FinCEN Form 111 Bank Secrecy Act Suspicious Activity Report BSA-SAR v37.3 (9-8-11).pdf	Form

IC Title:

Suspicious Activity Report by Depository Institutions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 31 CFR 1020.320

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	FinCEN Form 111	Bank Secrecy Act Suspicious Activity Report	BSA-SAR v37.3 (9-8-11).pdf		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	-672,296	672,297
Annual IC Time Burden (Hours)	1	-1,344,593	1,344,594
Annual IC Cost Burden (Dollars)	0	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.