Information Collection

Application Forms

IC 222949 under ICR 201608-3170-002 · OMB 3170-0068.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0068 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
cfpb_financial_coaching_initiative_form_r2-1.pdf	Other-Application for Financial Coac
cfpb_tax_assistance_program_form_r2-1.pdf	Other-Application for Tax Assistance
cfpb_ymyg_ cohort_application_r4-1.pdf	Other-Application for YMYG Cohort

IC Title:

Application Forms

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application for YMYG Cohort	cfpb_ymyg_ cohort_application_r4-1.pdf	Yes	Yes	Fillable Fileable
Other-Application for Financial Coaching Initiative	cfpb_financial_coaching_initiative_form_r2-1.pdf	Yes	Yes	Fillable Fileable
Other-Application for Tax Assistance Program	cfpb_tax_assistance_program_form_r2-1.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB.021 CFPB Consumer Education and Engagement Records, 77 F.R. 60382

FR Citation: 77 FR 60382

Number of Respondents: 285

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	325	325
Annual IC Time Burden (Hours)	1,625	1,625
Annual IC Cost Burden (Dollars)	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.