Information Collection

Debt Collection Disclosure Focus Groups

IC 211613 under ICR 201206-3170-002 · OMB 3170-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FINAL Debt Disclosure_Consent Form_2014_5-14-14.pdf	Other-Informed Consent
Debt Disclosure UX Discussion Guide_2014-5-14.docx.pdf	Other-Discussion Guide for User Expe
Debt Disclosure FG Discussion Guide_2014-5-14.docx.pdf	Other-Discussion Guide for Focus Gro
G-Notice 2_2014-5-14.docx.pdf	Other-Sample Collection Notice #2
G-Notice 1_2014-5-14.docx.pdf	Other-Sample Collection Notice #1
Debt Disclosure FG_Section E_Rights Activity_2014-5-5 PRIV_PRA.docx.pdf	Other-Focus Group activity hand out
Debt Disclosure_Screener.pdf	Other-Web and Phone Screeners
Debt Disclosure Privacy Statement_2014-5-14.docx.pdf	Other-Privcy Act Statement Handout
Debt Disclosure_Pre-Session Questionnaire_2014-5-14.pdf	Other-Pre-session questionaire
IC Template_Debt Disclosure 5-14-14.pdf Submission Template	IC Document
Debt Disclosure_Recruitment Plan.pdf Debt Collection Recruitment Plan	IC Document

IC Title:

Debt Collection Disclosure Focus Groups

Agency IC Tracking Number:

TI 10038

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Informed Consent	FINAL Debt Disclosure_Consent Form_2014_5-14-14.pdf	No		Paper Only
Other-Discussion Guide for User Experience Group	Debt Disclosure UX Discussion Guide_2014-5-14.docx.pdf	No		Paper Only
Other-Discussion Guide for Focus Group	Debt Disclosure FG Discussion Guide_2014-5-14.docx.pdf	No		Paper Only
Other-Sample Collection Notice #2	G-Notice 2_2014-5-14.docx.pdf	No		Paper Only
Other-Sample Collection Notice #1	G-Notice 1_2014-5-14.docx.pdf	No		Paper Only
Other-Focus Group activity hand out	Debt Disclosure FG_Section E_Rights Activity_2014-5-5 PRIV_PRA.docx.pdf	No		Paper Only
Other-Web and Phone Screeners	Debt Disclosure_Screener.pdf	Yes	Yes	Fillable Fileable
Other-Privcy Act Statement Handout	Debt Disclosure Privacy Statement_2014-5-14.docx.pdf	No		Printable Only
Other-Pre-session questionaire	Debt Disclosure_Pre-Session Questionnaire_2014-5-14.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB Consumer Education and Engagement Records

FR Citation: 77 FR 60382

Number of Respondents: 140

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	290	290
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Submission Template	IC Template_Debt Disclosure 5-14-14.pdf	05/21/2014
Debt Collection Recruitment Plan	Debt Disclosure_Recruitment Plan.pdf	05/14/2014

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