Chartering and Field of Membership Manual, 12 CFR 701.1, App. B to Part 701

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NCUA 9501 Certificate of Resolutions	Form	Unchanged	Available
Form NCUA 9500 Application and Agreements for Insurance of Accounts	Form	Unchanged	Available
Form NCUA 4012 Report of Official and Agreement to Serve	Form	Unchanged	Available
Form NCUA 4008 Organization Certificate	Form	Unchanged	Available
Form NCUA 4001 Conversion of State Charter to Federal Charter, Federal Credit Union Investigation Report	Form	Unchanged	Available
Form NCUA 9600 Information to be Provided in Support of the Application of a State Chartered Credit Union for Insurance of Accounts	Form and Instruction	Unchanged	Available
Form NCUA 9501 Certification of Resolutions	Form	Unchanged	Repair queued
Form NCUA 9500 Application and Agreements for Insurance of Accounts	Form	Unchanged	Available
Form NCUA 4506 Federal to State Conversion Ballot for Conversion Proposal	Form	Unchanged	Available
Form NCUA 4505 Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union	Form	Unchanged	Available
Form NCUA 4401 Application to Convert from a State to a Federal Credit Union	Form and Instruction	Unchanged	Available
Form NCUA 4221 Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union	Form	Unchanged	Available
Form NCUA 4000 Conversion of State Charter to Federal Charter	Form and Instruction	Unchanged	Available
Form NCUA 4015-EZ Application for Field of Membership Amendment	Form	Unchanged	Available
Form NCUA 4015 Application for Field of Membership Amendment	Form	Unchanged	Available
0015 Non-substantive change request2015.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-06-30	Available
0015FINALSupporting Statement2013.pdf	Supporting Statement A	Uploaded 2013-11-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
32675	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Form	Unchanged	Certificate of Resolutions
32675	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Form	Unchanged	Application and Agreements for Insurance of Accounts
32675	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Form	Unchanged	Report of Official and Agreement to Serve
32675	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Form	Unchanged	Organization Certificate
32675	Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	Form	Unchanged	Conversion of State Charter to Federal Charter, Federal Credit Union Investigation Report
209409	Charter Conversions	Form and Instruction	Unchanged	Information to be Provided in Support of the Application of a State Chartered Credit Union for Insurance of Accounts
209409	Charter Conversions	Form	Unchanged	Certification of Resolutions
209409	Charter Conversions	Form	Unchanged	Application and Agreements for Insurance of Accounts
209409	Charter Conversions	Form	Unchanged	Federal to State Conversion Ballot for Conversion Proposal
209409	Charter Conversions	Form	Unchanged	Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union
209409	Charter Conversions	Form and Instruction	Unchanged	Application to Convert from a State to a Federal Credit Union
209409	Charter Conversions	Form	Unchanged	Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union
209409	Charter Conversions	Form and Instruction	Unchanged	Conversion of State Charter to Federal Charter
209408	Application to Add an Underserved Area		Unchanged
209407	Community Charter Conversion and Expansion Applications		Unchanged
209406	Single Common Bond and Multiple Common Bond Amendments	Form	Unchanged	Application for Field of Membership Amendment
209406	Single Common Bond and Multiple Common Bond Amendments	Form	Unchanged	Application for Field of Membership Amendment

ICR Details

OMB Control No: 3133-0015	ICR Reference No: 201506-3133-003
Status: Historical Active	Previous ICR Reference No: 201311-3133-003
Agency/Subagency: NCUA	Agency Tracking No:
Title: Chartering and Field of Membership Manual, 12 CFR 701.1, App. B to Part 701
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/06/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/30/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	02/28/2017	02/28/2017
Responses	9,990	0	9,990
Time Burden (Hours)	15,398	0	15,398
Cost Burden (Dollars)	0	0	0

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Abstract: The FCU Act requires NCUA to administer chartering and field of membership requirements for FCUs. This is implemented through the Chartering and Field of Membership (Chartering) Manual as incorporated into NCUA regulations at 12 CFR 701.1 and Appendix B to Part 701. The Chartering Manual requires credit unions to prepare and submit forms with regard to chartering, field of membership amendments, service to underserved areas, and conversions from federal to state credit unions and state to federal credit unions.

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Authorizing Statute(s): US Code: 12 USC 1759 Name of Law: Federal Credit Union Act, Membership
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 52216	08/22/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 59977	09/30/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Application to Add an Underserved Area
Business Plan for New Charters, Wording for Proposed Field of Membership (FOM)	NCUA 4001, NCUA 4008, NCUA 9500, NCUA 4012, NCUA 9501	Conversion of State Charter to Federal Charter, Federal Credit Union Investigation Report ,   Organization Certificate ,   Report of Official and Agreement to Serve ,   Application and Agreements for Insurance of Accounts ,   Certificate of Resolutions
Charter Conversions	NCUA 4000, NCUA 4221, NCUA 4401, NCUA 4505, NCUA 4506, NCUA 9500, NCUA 9501, NCUA 9600	Conversion of State Charter to Federal Charter ,   Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union ,   Application to Convert from a State to a Federal Credit Union ,   Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union ,   Federal to State Conversion Ballot for Conversion Proposal ,   Application and Agreements for Insurance of Accounts ,   Certification of Resolutions ,   Information to be Provided in Support of the Application of a State Chartered Credit Union for Insurance of Accounts
Community Charter Conversion and Expansion Applications
Single Common Bond and Multiple Common Bond Amendments	NCUA 4015, NCUA 4015-EZ	Application for Field of Membership Amendment ,   Application for Field of Membership Amendment

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	9,990	9,990	0	0	0	0
Annual Time Burden (Hours)	15,398	15,398	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This collection is a reinstatement and also incorporates burdens from other prior collections, which have since been combined, including 3133-0116 and 3133-0178. The revisions update the number of respondents and burden hours.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/30/2015

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