Information Collection Request

Chartering and Field of Membership Manual, 12 CFR 701.1, App. B to Part 701

ICR 201311-3133-003 · OMB 3133-0015 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form NCUA 4001 Business Plan for New Charters, Wording for Proposed Field of Membership (FOM) Form Modified Available
Form NCUA 4000 Charter Conversions Form and Instruction New Available
Form NCUA 4015 Single Common Bond and Multiple Common Bond Amendments Form New Available
0015FINALSupporting Statement2013.pdf Supporting Statement A Uploaded 2013-11-21 Available

IC Document Collections

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved
9,990 0 0
15,398 0 0
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Business Plan for New Charters, Wording for Proposed Field of Membership (FOM) NCUA 4001, NCUA 4008, NCUA 9500, NCUA 4012, NCUA 9501 Conversion of State Charter to Federal Charter, Federal Credit Union Investigation Report ,   Organization Certificate ,   Report of Official and Agreement to Serve ,   Application and Agreements for Insurance of Accounts ,   Certificate of Resolutions
Single Common Bond and Multiple Common Bond Amendments NCUA 4015, NCUA 4015-EZ Application for Field of Membership Amendment ,   Application for Field of Membership Amendment
Community Charter Conversion and Expansion Applications
Application to Add an Underserved Area
Charter Conversions NCUA 4000, NCUA 4221, NCUA 4401, NCUA 4505, NCUA 4506, NCUA 9500, NCUA 9501, NCUA 9600 Conversion of State Charter to Federal Charter ,   Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union ,   Application to Convert from a State to a Federal Credit Union ,   Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union ,   Federal to State Conversion Ballot for Conversion Proposal ,   Application and Agreements for Insurance of Accounts ,   Certification of Resolutions ,   Information to be Provided in Support of the Application of a State Chartered Credit Union for Insurance of Accounts

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 9,990 0 0 9,365 0 625
Annual Time Burden (Hours) 15,398 0 0 -10,252 0 25,650
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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