Information Collection

Student Loan Repayment Loan Form Testing

IC 223202 under ICR 201512-3170-001 · OMB 3170-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0022 can be found here:

Documents and Forms

Document Name Document Type
Payback Playbook Testing Discussion Guide - OMB.pdf Other-Discussion Guide
Payback Playbook Disclosure Forms_1_and2_ - OMB.pdf Other-Disclosure Form
Payback Playbook_WaitingRoomWorksheet - OMB.pdf Other-Worksheet
CFPB TO16_Student Loans Form Testing Screener - OMB.pdf Other-Screeners
IC Template 3170-0022 (Student Loan Repayment Disclosure Testing) -OMBL.pdf Supporting Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Student Loan Repayment Loan Form Testing	Agency IC Tracking Number:	10786

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Discussion Guide	Payback Playbook Testing Discussion Guide - OMB.pdf		No		Paper Only
Other-Disclosure Form	Payback Playbook Disclosure Forms_1_and2_ - OMB.pdf		No		Paper Only
Other-Worksheet	Payback Playbook_WaitingRoomWorksheet - OMB.pdf		No		Paper Only
Other-Screeners	CFPB TO16_Student Loans Form Testing Screener - OMB.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title: CFPB 021 Consumer Education and Engagement Records	FR Citation: 79 FR 78839

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 73 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	234	234
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	IC Template 3170-0022 (Student Loan Repayment Disclosure Testing) -OMBL.pdf	08/25/2016

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