Information Collection

Application for Conversion

IC 19815 under ICR 201601-7100-009 · OMB 7100-0335.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 1680 Application for Conversion	Form and Instruction
Form 1680 Application for Conversion Form1680_Form1681_Form1682_Form1683_20150731_f.pdf www.federalreserve.gov/apps/reportforms/default.aspx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Form 1680

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	Form 1680	Application for Conversion	Form1680_Form1681_Form1682_Form1683_20150731_f.pdf	http://www.federalreserve.gov/apps/reportforms/default.aspx	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	-20	30
Annual IC Time Burden (Hours)	2,990	-12,310	15,300
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.