Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0015 can be found here:

Documents and Forms

Document Name Document Type
Form NCUA 4001 Business Plan for New Charters, Wording for Proposed Field of Membership (FOM) Form
NCUA 4001 Conversion of State Charter to Federal Charter, Federal NCUA_4001- IC 1 of 3133-0015.pdf www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx Form
NCUA 4008 Organization Certificate NCUA_4008-IC 1 of 3133-0015.pdf www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx Form
NCUA 4012 Report of Official and Agreement to Serve NCUA_4012-IC 1 of 3133-0015.pdf www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx Form
NCUA 9500 Application and Agreements for Insurance of Accounts NCUA_9500-IC 1 of 3133-0015.pdf www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx Form
NCUA 9501 Certificate of Resolutions NCUA_9501-IC 1 of 3133-0015.pdf www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx Form

Information Collection (IC) Details

IC Title:	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 701

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NCUA 4001	Conversion of State Charter to Federal Charter, Federal Credit Union Investigation Report	NCUA_4001- IC 1 of 3133-0015.pdf	http://www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx	Yes	Yes	Fillable Fileable Signable
Form	NCUA 4008	Organization Certificate	NCUA_4008-IC 1 of 3133-0015.pdf	http://www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx	Yes	Yes	Fillable Fileable Signable
Form	NCUA 4012	Report of Official and Agreement to Serve	NCUA_4012-IC 1 of 3133-0015.pdf	http://www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx	Yes	Yes	Fillable Fileable Signable
Form	NCUA 9500	Application and Agreements for Insurance of Accounts	NCUA_9500-IC 1 of 3133-0015.pdf	http://www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx	Yes	Yes	Fillable Fileable Signable
Form	NCUA 9501	Certificate of Resolutions	NCUA_9501-IC 1 of 3133-0015.pdf	http://www.ncua.gov/Legal/GuidesEtc/Pages/Chartering-Manual.aspx	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	2	-623	625
Annual IC Time Burden (Hours)	320	-25,330	25,650
Annual IC Cost Burden (Dollars)	0	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.