Information Collection

New Periodic Statement (Depository Institutions)

IC 204934 under ICR 201301-3170-003 · OMB 3170-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0028 can be found here:

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IC Title:

New Periodic Statement (Depository Institutions)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1026

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

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18,704,400	18,704,400
Annual IC Time Burden (Hours)	56,113	56,113
Annual IC Cost Burden (Dollars)	2,051,418	2,051,418

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.