Application for Non-Profit Budget and Credit Counseling Agencies

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0084 can be found here:

Documents and Forms

Document Name Document Type
Form XXXX Application for Non-Profit Budget and Credit Counseling Agencies Form
1105-0084 CC Instructions (final rule)_080713.doc Instruction
XXXX CC Application 1105-0084CC Application (final rule)_080713.doc Form
CC Appendix A XXXX 1105-0084 CC Appendix A (final rule)_080713.doc Form
CC Appendix B XXXX 1105-0084 CC Appendix B (final rule)_080713.doc Form
XXX CC Appendix C 1105-0084 CC Appendix C (final rule)_080713.doc Form
XXXX CC Appendix D 1105-0084 CC Appendix D (final rule)_080713.doc Form
XXXX CC Appendix E 1105-0084 CC Appendix E (final rule)_080713.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Non-Profit Budget and Credit Counseling Agencies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	XXXX	CC Application	1105-0084CC Application (final rule)_080713.doc	Yes	Yes	Fillable Fileable Signable
Instruction			1105-0084 CC Instructions (final rule)_080713.doc	Yes	No	Fillable Printable
Form	CC Appendix A	XXXX	1105-0084 CC Appendix A (final rule)_080713.doc	Yes	No	Fillable Printable
Form	CC Appendix B	XXXX	1105-0084 CC Appendix B (final rule)_080713.doc	Yes	No	Fillable Printable
Form	XXX	CC Appendix C	1105-0084 CC Appendix C (final rule)_080713.doc	Yes	No	Fillable Printable
Form	XXXX	CC Appendix D	1105-0084 CC Appendix D (final rule)_080713.doc	Yes	No	Fillable Printable
Form	XXXX	CC Appendix E	1105-0084 CC Appendix E (final rule)_080713.doc	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 175	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	808	808
Annual IC Cost Burden (Dollars)	8,750	8,750

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.