Information Collection

Application and Related Forms

IC 204699 under ICR 201607-3170-001 · OMB 3170-0037.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0037 can be found here:

Documents and Forms

Document Name Document Type
Application to Serve as a Small Entity Representative 4_6.pdf Other-Application to Serve as a Smal
cfpb_OD_ARC_Application_040616.pdf Other-ARC Application
cfpb_OD_CAB_Application_040616.pdf Other-CAB Application
cfpb_OD_CBAC_CUAC_Application_040616.pdf Other-CBAC CUAC Application
CFPB Travel Information Form.pdf Other-CFPB Travel Form
TSA Travel Information Form 4_6.pdf Other-TSA Travel Form
FBI Name Check Form 4_6.pdf Other-FBI Name Check Form
Consumer Advisory Board Member Survey 4_6.pdf Other-CAB Member Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application and Related Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application to Serve as a Small Entity Rep	Application to Serve as a Small Entity Representative 4_6.pdf	Yes	Yes	Fillable Fileable
Other-ARC Application	cfpb_OD_ARC_Application_040616.pdf	Yes	Yes	Fillable Fileable
Other-CAB Application	cfpb_OD_CAB_Application_040616.pdf	No		Fillable Fileable
Other-CBAC CUAC Application	cfpb_OD_CBAC_CUAC_Application_040616.pdf	Yes	Yes	Fillable Fileable
Other-CFPB Travel Form	CFPB Travel Information Form.pdf	Yes	Yes	Fillable Fileable
Other-TSA Travel Form	TSA Travel Information Form 4_6.pdf	Yes	Yes	Fillable Fileable
Other-FBI Name Check Form	FBI Name Check Form 4_6.pdf	Yes	Yes	Fillable Fileable
Other-CAB Member Survey	Consumer Advisory Board Member Survey 4_6.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title: Advisory Boards and Committees	FR Citation: 77 FR 12034

Number of Respondents: 425	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	805	-895	1,700
Annual IC Time Burden (Hours)	503	-772	1,275
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.