Information Collection

Research in Development of Disclosure Forms

IC 204813 under ICR 201111-3170-001 · OMB 3170-0003.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
LE_Balloon_Engl_11-8-12.pdf.pdf	Other-Sample Form
LE_Balloon_Spanish_11-8-12.pdf.pdf	Other-Sample Form
CD_IO_Engl_11-8-12.pdf.pdf	Other-Sample Form
CD_IO_Spanish_11-8-12.pdf.pdf	Other-Sample Form
Round_2_Spanish_Moderators_Guide_Consumer_ FINAL ENGLISH-11-6-12.docx	Instruction
OMB Memo on Round 12 FINAL 1109.docx Supplemental Supporting Statement	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Electronic Capability
Other-Sample Form	No	Printable Only
Other-Sample Form	No	Printable Only
Other-Sample Form	No	Printable Only
Other-Sample Form	No	Printable Only
Instruction	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supplemental Supporting Statement		11/13/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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