Information Collection

Application for Debt Education Course Provider

IC 11783 under ICR 201302-1105-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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_Debtor Education Instructions_030513.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
XXXX Debtor Education Application 1105-0085_Debtor Education Application_030513.doc Form

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
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
Form	xxxx	DE Application Appendi E	1105-0085_DE Application Appendix E (Feb 13).doc	Yes	Yes	Fillable Fileable Signable
Form	XXXX	Debtor Education Application	1105-0085_Debtor Education Application_030513.doc	Yes	Yes	Fillable Fileable Signable
Instruction			1105-0085_Debtor Education Instructions_030513.doc	Yes	No	Fillable Printable

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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	275	275
Annual IC Time Burden (Hours)	24,076	24,076
Annual IC Cost Burden (Dollars)	13,750	13,750

Documents for IC

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.