Information Collection

Diversity Assessment Report

IC 218876 under ICR 201610-3235-026 · OMB 3235-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DRAFT DRAFT Diversity Assesment Form Diversity Assessment Report	Form and Instruction
Final Interagency Policy Statement.pdf	Other-Policy Statement
DRAFT DRAFT Diversity Assesment Form 2017.09.25 Diversity Assessment Report DV11.docx	Form and Instruction

IC Title:

Diversity Assessment Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-Policy Statement					Yes	Yes	Fillable Fileable Signable
Form and Instruction	DRAFT				Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,500	250	1,250
Annual IC Time Burden (Hours)	7,500	-7,500	15,000
Annual IC Cost Burden (Dollars)	0	-520,000	520,000

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.

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