Information Collection

Quarterly Supplemental Reports

IC 196205 under ICR 201412-1505-004 · OMB 1505-0228.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0228 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TD_F_102.4_QSR_banks_and_savings_associations_20130503_v6.pdf www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Other-report
TD_F_102.4_QSR_holding_companies_20130503_v6.pdf www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Other-report
TD_F_102.3A_QSR_CDLFs_2012_v5.pdf www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Other-report
Instructions_for_QSR_banks_and_savings_associations_v6.pdf	Instruction
Instructions_for_QSR_holding_companies_v6.pdf	Instruction
Instructions_for_QSR_CDLFs_v5.pdf	Instruction

IC Title:

Quarterly Supplemental Reports

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-report	TD_F_102.4_QSR_banks_and_savings_associations_20130503_v6.pdf	http://www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Yes	No	Fillable Printable
Other-report	TD_F_102.4_QSR_holding_companies_20130503_v6.pdf	http://www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Yes	No	Fillable Printable
Other-report	TD_F_102.3A_QSR_CDLFs_2012_v5.pdf	http://www.treasury.gov/resource-center/sb-programs/Pages/Supplemental-Reporting-Requirements.aspx	Yes	No	Fillable Printable
Instruction	Instructions_for_QSR_banks_and_savings_associations_v6.pdf		Yes	No	Printable Only
Instruction	Instructions_for_QSR_holding_companies_v6.pdf		Yes	No	Printable Only
Instruction	Instructions_for_QSR_CDLFs_v5.pdf		Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 288

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,152	-176	1,328
Annual IC Time Burden (Hours)	4,032	-1,280	5,312
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.