Information Collection

12 CFR 5.47(d)(3)(ii)(C)

IC 214041 under ICR 201411-1557-003 · OMB 1557-0320.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1557-0320 can be found here:

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Information Collection (IC) Details

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IC Title:	12 CFR 5.47(d)(3)(ii)(C)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

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