Information Collection

Payroll Disclosures

IC 200268 under ICR 201305-3170-001 · OMB 3170-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0014 can be found here:

Documents and Forms

Document Name Document Type
A-30 Form 1.11.12.doc Other-Model Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Payroll Disclosures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1005

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Model Form			A-30 Form 1.11.12.doc		No		Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600,000	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	600,000	600,000
Annual IC Time Burden (Hours)	900,000	900,000
Annual IC Cost Burden (Dollars)	0	0

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.