Advisory Boards, Groups and Committees

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3170-XXXX TSA Travel Information Form	Form and Instruction	New	Available
Form 3170-XXXX Survey - Consumer Advisory Board Member	Form and Instruction	New	Available
Form 3170-XXXX CFPB FBI Name Check Form	Form	New	Available
Form 3170-XXXX CFPB IRS Tax Check Waiver Form	Form	New	Available
Form 3170-XXXX Panel Application Form	Form	New	Available
Form 3170-XXXX Certifications	Form	New	Available
Form 3170-XXXX Nomination Form	Form	New	Available
CAB Supporting Statement [FINAL] (11.29.2012).pdf	Supporting Statement A	Uploaded 2012-11-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204968	TSA Travel Information Form	Form and Instruction	New
204967	Survey - Consumer Advisory Board Member	Form and Instruction	New
204714	CFPB FBI Name Check Form	Form	New
204713	CFPB IRS Tax Check Waiver Form	Form	New
204701	Panel Application Form	Form	New
204700	Certifications	Form	New
204699	Nomination Form	Form	New

ICR Details

OMB Control No: 3170-0037	ICR Reference No: 201211-3170-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: CFPB	Agency Tracking No:
Title: Advisory Boards, Groups and Committees
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 04/23/2013
	Date Received in OIRA: 12/06/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: On July 21, 2010, President Barack Obama signed into law the Dodd-Frank Wall Street Reform and Consumer Protection Act, P.L. 111-203, 124 Stat. 1376 (2010) (Dodd-Frank Act). Title X of the Dodd-Frank Act created the Consumer Financial Protection Bureau (CFPB or the Bureau) and provides that the Director of the CFPB "shall establish a Consumer Advisory Board to advise and consult with the Bureau in the exercise of its functions under the Federal consumer financial laws, and to provide information on emerging practices in the consumer financial products or services industry, including regional trends, concerns, and other relevant information." See Dodd-Frank Act § 1014. The Bureau seeks a clearance from OMB to collect selection-related information from nominees to the Consumer Advisory Board (CAB), such as background information, information related to financial holdings, and other supplemental information relevant to the application process. The Bureau may collect similar information from potential candidates for other Advisory Groups, members of other Advisory Groups, and Special Advisors to the CAB and other Advisory Groups, as relevant to the particular group. The Bureau may use this information to screen potential candidates for, members of, and advisors to CAB and other Advisory Groups for status as a federally registered lobbyist and/or status as a convicted felon.

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Authorizing Statute(s): PL: Pub.L. 111 - 203 1014(b) Name of Law: Dodd-Frank Wall Street Reform and Consumer Protection Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 11073	02/24/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 32594	06/01/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Nomination Form	3170-XXXX, 3170-XXXX, 3170-XXXX, 3170-XXXX, 3170-XXXX, 3170-XXXX, 3170-XXXX	Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Background Information - Short Form) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Background Information - Long Form) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Positions) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Liabilities) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Affiliations and Representations) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Assets and Income) ,   Application to Serve on Advisory Board, Body, Panel, Committee, or Group (Full Version)
Certifications	3170-XXXX, 3170-XXXX, 3170-XXXX	Certification Regarding Financial Interests (Academic Research Council) ,   Certification for Entity-Specific Projects (Academic Research Council) ,   Certification for Non-Entity-Specific Projects (Academic Research Council)
Survey - Consumer Advisory Board Member	3170-XXXX	Consumer Advisory Board Member Survey
TSA Travel Information Form	3170-XXXX	TSA Travel Information Form
CFPB IRS Tax Check Waiver Form	3170-XXXX	CFPB IRA Tax Check Waiver Form
CFPB FBI Name Check Form	3170-XXXX	CFPB FBI Name Check Form
Panel Application Form	3170-XXXX	Application to Serve as a Small Entity Representative

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This ICR is necessary for the creation of advisory boards, groups, and committees at the Bureau, and will be used to collect information from potential members of those boards, groups, and committees.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Yes

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/06/2012

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