Information Collection

Application for Financing

IC 35919 under ICR 201205-3420-005 · OMB 3420-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3420-0015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OPIC-115 Application for Financing	Form and Instruction
OPIC-115 Application for Financing Revised OPIC 115-E-form-2012.docx	Form and Instruction
OPIC Form 115 - Justification Statement.pdf OPIC form 115 Justification Statement	IC Document

IC Title:

Application for Financing

Agency IC Tracking Number:

OPIC-115

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 1320.9

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 and Instruction	OPIC-115	Application for Financing	Revised OPIC 115-E-form-2012.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 1

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	100	150
Annual IC Time Burden (Hours)	438	145	293
Annual IC Cost Burden (Dollars)	18,750	18,750	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OPIC form 115 Justification Statement	OPIC Form 115 - Justification Statement.pdf	05/16/2012

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