Information Collection

Application for Debt Education Course Provider

IC 11783 under ICR 201208-1105-002 · OMB 1105-0085.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0085 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form xxxx Application for Debt Education Course Provider	Form
1105-0085_05-DE_Instructions_Universities_080112.pdf	Other-Supplemental Instructions
1105-0085_04-Debtor Education Instructions_080112.doc	Instruction
xxxx DE Application Appendix A 1105-0085_07-DE_Application_Appendix_A_080112.pdf	Form
xxxx DE Application Appendix B 1105-0085_08-DE_Application_Appendix_B_080112.pdf	Form
xxxx DE Application Appendix C 1105-0085_09-DE_Application_Appendix_C_080112.pdf	Form
xxxx DE Application Appendix D 1105-0085_10-DE_Application_Appendix_D_080112.pdf	Form
xxxx DE Application Appendi E 1105-0085_DE Application Appendix E (Feb 13).doc	Form

IC Title:

Application for Debt Education Course Provider

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 1320.6

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	xxxx	DE Application Appendi E	1105-0085_DE Application Appendix E (Feb 13).doc	Yes	Yes	Fillable Fileable Signable
Form	xxxx	DE Application Appendix A	1105-0085_07-DE_Application_Appendix_A_080112.pdf	Yes	Yes	Fillable Fileable Signable
Form	xxxx	DE Application Appendix B	1105-0085_08-DE_Application_Appendix_B_080112.pdf	Yes	Yes	Fillable Fileable Signable
Form	xxxx	DE Application Appendix C	1105-0085_09-DE_Application_Appendix_C_080112.pdf	Yes	Yes	Fillable Fileable Signable
Form	xxxx	DE Application Appendix D	1105-0085_10-DE_Application_Appendix_D_080112.pdf	Yes	Yes	Fillable Fileable Signable
Other-Supplemental Instructions			1105-0085_05-DE_Instructions_Universities_080112.pdf	Yes	No	Printable Only
Instruction			1105-0085_04-Debtor Education Instructions_080112.doc	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 275

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	275	-25	300
Annual IC Time Burden (Hours)	24,076	21,076	3,000
Annual IC Cost Burden (Dollars)	13,750	-136,250	150,000

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.