Information Collection

Application for Non-Profit Budget and Credit Counseling Agencies

IC 11781 under ICR 201308-1105-001 · OMB 1105-0084.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.