Consumer Advisory Boards, Groups and Committees

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3170-XXXX FBI Name Check Form	Form and Instruction	New	Available
Form 3170-XXXX CFPB Travel Form	Form and Instruction	New	Available
Form 3170-XXXX TSA Travel Information Form	Form and Instruction	Modified	Available
Form 3170-XXXX Consumer Advisory Board Member Survey	Form and Instruction	Modified	Available
Form 3170-XXXX CFPB FBI Name Check Form	Form	Removed	Available
Form 3170-XXXX CFPB IRA Tax Check Waiver Form	Form	Removed	Available
Form 3170-XXXX Application to Serve as a Small Entity Representative	Form	Modified	Available
Form 3170-XXXX Certification for Non-Entity-Specific Projects (Academic Research Council)	Form	Modified	Available
Form 3170-XXXX Certification for Entity-Specific Projects (Academic Research Council)	Form	Modified	Available
Form 3170-XXXX Certification Regarding Financial Interests (Academic Research Council)	Form	Modified	Available
Form 3170-XXXX Application to Serve on Advisory Board	Form and Instruction	Modified	Repair queued
Advisory Boards Groups and Committees Supporting Statement (Revised 5.23.2013).pdf	Supporting Statement A	Uploaded 2013-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
207063	FBI Name Check Form	Form and Instruction	New	FBI Name Check Form
206685	CFPB Travel Form	Form and Instruction	New	CFPB Travel Form
204968	TSA Travel Information Form	Form and Instruction	Modified	TSA Travel Information Form
204967	Consumer Advisory Board Post Meeting Survey	Form and Instruction	Modified	Consumer Advisory Board Member Survey
204714	CFPB FBI Name Check Form	Form	Removed	CFPB FBI Name Check Form
204713	CFPB IRS Tax Check Waiver Form	Form	Removed	CFPB IRA Tax Check Waiver Form
204701	Application to Serve as a Small Entity Representative	Form	Modified	Application to Serve as a Small Entity Representative
204700	Certifications	Form	Modified	Certification for Non-Entity-Specific Projects (Academic Research Council)
204700	Certifications	Form	Modified	Certification for Entity-Specific Projects (Academic Research Council)
204700	Certifications	Form	Modified	Certification Regarding Financial Interests (Academic Research Council)
204699	Application to Serve on Advisory Board	Form and Instruction	Modified	Application to Serve on Advisory Board

ICR Details

OMB Control No: 3170-0037	ICR Reference No: 201304-3170-003
Status: Historical Active	Previous ICR Reference No: 201211-3170-001
Agency/Subagency: CFPB	Agency Tracking No:
Title: Consumer 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: Approved without change	Conclusion Date: 07/08/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/25/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved
Responses	6,400	0	0
Time Burden (Hours)	2,496	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."

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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
Application to Serve as a Small Entity Representative	3170-XXXX	Application to Serve as a Small Entity Representative
Application to Serve on Advisory Board	3170-XXXX	Application to Serve on Advisory Board
CFPB FBI Name Check Form	3170-XXXX	CFPB FBI Name Check Form
CFPB IRS Tax Check Waiver Form	3170-XXXX	CFPB IRA Tax Check Waiver Form
CFPB Travel Form	3170-XXXX	CFPB Travel Form
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)
Consumer Advisory Board Post Meeting Survey	3170-XXXX	Consumer Advisory Board Member Survey
FBI Name Check Form	3170-XXXX	FBI Name Check Form
TSA Travel Information Form	3170-XXXX	TSA Travel Information Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	6,400	0	0	6,600	-200	0
Annual Time Burden (Hours)	2,496	0	0	2,530	-34	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: New collection of information.

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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: 04/25/2013

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