Information Collection

CFPB's Consumer Response Intake Form Improvement Study

IC 223946 under ICR 201504-3170-002 · OMB 3170-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0042 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CFPB's Consumer Response Intake Form Improvement Study	Form and Instruction
Consumer Response Intake Form Net new complaint form fields.pdf www.consumerfinance.gov/complaint	Form and Instruction
IC Template - 3170-0042 (Product_Issue_Test Final).pdf IC Template	IC Document

IC Title:

CFPB's Consumer Response Intake Form Improvement Study

Agency IC Tracking Number:

DI00442

IC Status: New

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	NA	Consumer Response Intake Form	Net new complaint form fields.pdf	www.consumerfinance.gov/complaint	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: 110,241

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	110,241	110,241
Annual IC Time Burden (Hours)	27,807	27,807
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IC Template	IC Template - 3170-0042 (Product_Issue_Test Final).pdf	10/14/2016

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