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 4001 FCU Investigation Report	Form and Instruction	Modified	Available
Form NCUA 4506 Federal to State Conversion - Ballot for Conversion Proposal	Form	Modified	Available
Form NCUA 4505 Affidavit - Proof of Results Membership Vote	Form	Modified	Available
Form NCUA 4401 Application to Convert From a State to a Federal CU	Form	Modified	Available
Form NCUA 4221 Notice of Meeting of Members to Convert from a Federal to a State Chartered CU	Form	Modified	Available
Form NCUA 4000 Conversions of State Charter to Federal Charter (FCU Investigation Report)	Form	Modified	Available
Form NCUA 4015-A Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 to 4,999)	Form	Modified	Available
Form NCUA 4015-EZ Application FOM Amendment (Multiple Common Bond Expansions less than 3,000 and All Single Common Bond Expansions)	Form	Modified	Available
Form NCUA 4015 Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 or more)	Form	Modified	Available
Form NCUA 9501 Certification of Resolutions	Form	Modified	Available
Form NCUA 9500 Application and Agreements for Insurance of Accounts	Form	Modified	Available
Form NCUA 4012 Report of Official and Agreement to Serve	Form	Modified	Available
Form NCUA 4008 Organization Certification	Form	Modified	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	Removed	Available
Form NCUA 9501 Certification of Resolutions	Form	Removed	Available
Form NCUA 9500 Application and Agreements for Insurance of Accounts	Form	Removed	Repair queued
Form NCUA 4506 Federal to State Conversion Ballot for Conversion Proposal	Form	Removed	Available
Form NCUA 4505 Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union	Form	Removed	Available
Form NCUA 4401 Application to Convert from a State to a Federal Credit Union	Form and Instruction	Removed	Available
Form NCUA 4221 Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union	Form	Removed	Available
Form NCUA 4000 Conversion of State Charter to Federal Charter	Form and Instruction	Removed	Available
Form NCUA 4015-EZ Application for Field of Membership Amendment	Form	Removed	Available
Form NCUA 4015 Application for Field of Membership Amendment	Form	Removed	Available
NPRM_3133-0015_Supporting Statement_102416.doc	Supporting Statement A	Uploaded 2016-10-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
32675	Chartering and Field of Membership Manual	Form and Instruction	Modified	FCU Investigation Report
32675	Chartering and Field of Membership Manual	Form	Modified	Federal to State Conversion - Ballot for Conversion Proposal
32675	Chartering and Field of Membership Manual	Form	Modified	Affidavit - Proof of Results Membership Vote
32675	Chartering and Field of Membership Manual	Form	Modified	Application to Convert From a State to a Federal CU
32675	Chartering and Field of Membership Manual	Form	Modified	Notice of Meeting of Members to Convert from a Federal to a State Chartered CU
32675	Chartering and Field of Membership Manual	Form	Modified	Conversions of State Charter to Federal Charter (FCU Investigation Report)
32675	Chartering and Field of Membership Manual	Form	Modified	Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 to 4,999)
32675	Chartering and Field of Membership Manual	Form	Modified	Application FOM Amendment (Multiple Common Bond Expansions less than 3,000 and All Single Common Bond Expansions)
32675	Chartering and Field of Membership Manual	Form	Modified	Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 or more)
32675	Chartering and Field of Membership Manual	Form	Modified	Certification of Resolutions
32675	Chartering and Field of Membership Manual	Form	Modified	Application and Agreements for Insurance of Accounts
32675	Chartering and Field of Membership Manual	Form	Modified	Report of Official and Agreement to Serve
32675	Chartering and Field of Membership Manual	Form	Modified	Organization Certification
209409	Charter Conversions	Form and Instruction	Removed	Information to be Provided in Support of the Application of a State Chartered Credit Union for Insurance of Accounts
209409	Charter Conversions	Form	Removed	Certification of Resolutions
209409	Charter Conversions	Form	Removed	Application and Agreements for Insurance of Accounts
209409	Charter Conversions	Form	Removed	Federal to State Conversion Ballot for Conversion Proposal
209409	Charter Conversions	Form	Removed	Affidavit - Proof of Results of Membership Vote -- Proposed Conversion from a Federal Credit Union to State Credit Union
209409	Charter Conversions	Form and Instruction	Removed	Application to Convert from a State to a Federal Credit Union
209409	Charter Conversions	Form	Removed	Notice of Meeting of Members to Convert from a Federal to a State Chartered Credit Union
209409	Charter Conversions	Form and Instruction	Removed	Conversion of State Charter to Federal Charter
209408	Application to Add an Underserved Area		Removed
209407	Community Charter Conversion and Expansion Applications		Removed
209406	Single Common Bond and Multiple Common Bond Amendments	Form	Removed	Application for Field of Membership Amendment
209406	Single Common Bond and Multiple Common Bond Amendments	Form	Removed	Application for Field of Membership Amendment

ICR Details

OMB Control No: 3133-0015	ICR Reference No: 201602-3133-006
Status: Historical Inactive	Previous ICR Reference No: 201506-3133-003
Agency/Subagency: NCUA	Agency Tracking No: OCP
Title: Chartering and Field of Membership Manual, 12 CFR 701.1, App. B to Part 701
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 12/22/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/26/2016
Terms of Clearance: Pursuant to 5 CFR 1320.11(c), OMB files this comment on this information collection request (ICR). In accordance with 5 CFR 1320, OMB is withholding approval at this time. The agency shall examine public comment in response to the NPRM and will include in the supporting statement of the next ICR--to be submitted to OMB at the final rule stage--a description of how the agency has responded to any public comments on the ICR, including comments on maximizing the practical utility of the collection and minimizing the burden.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved	08/31/2017
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:
3133-AE31	Proposed rulemaking	80 FR 76748	12/10/2015

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Application to Add an Underserved Area
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
Chartering and Field of Membership Manual	NCUA 4015, 4001, NCUA 4015-A, NCUA 4000, NCUA 4221, NCUA 4505, NCUA 4506, NCUA 4012, NCUA 4008, NCUA 9500, NCUA 9501, NCUA 4015-EZ, NCUA 4401	Organization Certification ,   Report of Official and Agreement to Serve ,   Application and Agreements for Insurance of Accounts ,   Certification of Resolutions ,   Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 or more) ,   Application FOM Amendment (Multiple Common Bond Expansions less than 3,000 and All Single Common Bond Expansions) ,   Application FOM Amendment (Multiple Common Bond Expansion Groups of 3,000 to 4,999) ,   Conversions of State Charter to Federal Charter (FCU Investigation Report) ,   Notice of Meeting of Members to Convert from a Federal to a State Chartered CU ,   Application to Convert From a State to a Federal CU ,   Affidavit - Proof of Results Membership Vote ,   Federal to State Conversion - Ballot for Conversion Proposal ,   FCU Investigation Report
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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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: The adjustments are due to a reduction in the number of FCU and in the amount of time to complete the Field of Membership Forms, for a reduction 1,335 burden hours. The proposed rule permits an FCU to assemble subjective evidence of interaction or common interest, and to draft and submit a narrative summarizing the evidence to support its application to expand; for an increase of 26,160 burden hours, due to program change. Total burden hours requested 40,223.

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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: 10/26/2016

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