Information Collection

Retrieve and Submit Diversity Information

IC 219173 under ICR 201511-3133-001 · OMB 3133-0193.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0193 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CU Self Assessment Checklist v7 120815FINAL.pdf	Other-Checklist

IC Title:

Retrieve and Submit Diversity Information

Agency IC Tracking Number:

Is this a Common Form? No

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
Other-Checklist			CU Self Assessment Checklist v7 120815FINAL.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 367

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	367	367
Annual IC Time Burden (Hours)	4,404	4,404
Annual IC Cost Burden (Dollars)	409,572	409,572

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.