Information Collection

Small Dollar Lending Rule Disclosure Testing (Payday)

IC 217538 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⚠️ Notice: This information collection may be referencing outdated material.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
Small Loans Discussion Guide 7-1-15 (FINAL).pdf	Other-Discussion Guide
Draft Origination Forms 7-8-15.pdf	Other-Test Disclosure - Orgination
Draft Payment Forms 7-16-15.pdf	Other-Test Disclosure - Payment
Small Loans Informed Consent.7-30-15(OMB Revision).pdf	Other-Informed Consent
Small Loans Recruiting Language.7-30-15(OMB Revision).pdf	Other-Recruiting Language
Small Loans Screener.7-30-15 (OMB Revision).pdf	Other-Screener
20150701 RMR Small Dollar Lending Rule Disclosure Phone Confirmation Privacy Act Statement.pdf Privacy Act Statement - Phone Confermation	IC Document
20150701 RMR Small Dollar Lending Rule Disclosure Web Screener Privacy Act Statement.pdf Privacy Act Statement - Web Screener	IC Document
20150701 RMR Small Dollar Lending Rule Disclosure Moderators Guide Privacy Act Statement.pdf Privacy Act Statement - Interviews	IC Document
IC Template 3170-0022 Small Loans PAYDAY 7-30-15 (OMB Revision).docx IC Template - small loans (payday)	IC Document

IC Title:

Small Dollar Lending Rule Disclosure Testing (Payday)

Agency IC Tracking Number:

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-Discussion Guide	Small Loans Discussion Guide 7-1-15 (FINAL).pdf	No		Paper Only
Other-Test Disclosure - Orgination	Draft Origination Forms 7-8-15.pdf	No		Paper Only
Other-Test Disclosure - Payment	Draft Payment Forms 7-16-15.pdf	No		Paper Only
Other-Informed Consent	Small Loans Informed Consent.7-30-15(OMB Revision).pdf	No		Paper Only
Other-Recruiting Language	Small Loans Recruiting Language.7-30-15(OMB Revision).pdf	Yes	Yes	Fillable Fileable
Other-Screener	Small Loans Screener.7-30-15 (OMB Revision).pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB.022 Market and Consumer Research Records_

FR Citation: 77 FR 67802

Number of Respondents: 168

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	252	252
Annual IC Time Burden (Hours)	73	73
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Privacy Act Statement - Phone Confermation	20150701 RMR Small Dollar Lending Rule Disclosure Phone Confirmation Privacy Act Statement.pdf	07/20/2015
Privacy Act Statement - Web Screener	20150701 RMR Small Dollar Lending Rule Disclosure Web Screener Privacy Act Statement.pdf	07/20/2015
Privacy Act Statement - Interviews	20150701 RMR Small Dollar Lending Rule Disclosure Moderators Guide Privacy Act Statement.pdf	07/22/2015
IC Template - small loans (payday)	IC Template 3170-0022 Small Loans PAYDAY 7-30-15 (OMB Revision).docx	07/31/2015

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