Information Collection

Consumer Response Intake Forms

IC 198358 under ICR 201504-3170-001 · OMB 3170-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Consumer Response Intake Forms	Form
2015_3_3_Inventory of Questions for Consumer Response Intake Form(FINAL).pdf	Other-Inventory of Questions
Consumer Response Intake Instruments All Consumer Response Intake Instruments v3(FINAL).pdf	Form

IC Title:

Consumer Response Intake Forms

Agency IC Tracking Number:

TI 10266

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	N/A	Consumer Response Intake Instruments	All Consumer Response Intake Instruments v3(FINAL).pdf		Yes	Yes	Fillable Fileable
Other-Inventory of Questions			2015_3_3_Inventory of Questions for Consumer Response Intake Form(FINAL).pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB.005âConsumer Response System

FR Citation: 79 FR 21440

Number of Respondents: 3,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,000,000	2,250,000	750,000
Annual IC Time Burden (Hours)	387,500	262,500	125,000
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.