Information Collection

Application to Serve on Advisory Board

IC 204699 under ICR 201410-3170-002 · OMB 3170-0037.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0037 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3170-XXXX Application to Serve on Advisory Board	Form and Instruction
3170-XXXX Application to Serve on Advisory Board Application to Serve on Advisory Board.pdf	Form and Instruction
Application to Serve on Advisory Board Application to Serve on Advisory Board -rev 10-14.pdf	Form and Instruction
Application to Serve on Advisory Board -rev10-14Tracks.pdf Application to Serve on Advisory Board rev 10-14 Tracked	IC Document

IC Title:

Application to Serve on Advisory Board

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3170-XXXX	Application to Serve on Advisory Board	Application to Serve on Advisory Board.pdf		Yes	Yes	Fillable Printable
Form and Instruction	N/A	Application to Serve on Advisory Board	Application to Serve on Advisory Board -rev 10-14.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: Advisory Boards and Committees

FR Citation: 77 FR 12034

Number of Respondents: 1,700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,700	1,700
Annual IC Time Burden (Hours)	1,275	1,275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Application to Serve on Advisory Board rev 10-14 Tracked	Application to Serve on Advisory Board -rev10-14Tracks.pdf	10/16/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.