Information Collection

Telephone Survey

IC 207201 under ICR 201411-3170-002 · OMB 3170-0046.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2014_08_28_CLEAN APPX A.pdf	Other-Survey
2014_08_28_CLEAN APPX C.pdf	Other-Pre-notification Letter
2014_08_28_CLEAN APPX B- Questions_Justification.pdf Justification of Questions	IC Document
2014_08_28_CLEAN REV APPX D.pdf FAQs	IC Document

IC Title:

Telephone Survey

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
Other-Survey			2014_08_28_CLEAN APPX A.pdf		Yes	Yes	Fillable Fileable
Other-Pre-notification Letter			2014_08_28_CLEAN APPX C.pdf		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10,500	10,500
Annual IC Time Burden (Hours)	645	645
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification of Questions	2014_08_28_CLEAN APPX B- Questions_Justification.pdf	09/04/2014
FAQs	2014_08_28_CLEAN REV APPX D.pdf	09/04/2014

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