Designation of Exempt Person

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1506-0012 can be found here:

Documents and Forms

Document Name Document Type
Form FinCEN 110 Designation of Exempt Person Form and Instruction
FinCEN 110 Designation of Exempt Person DOEP.pdf bsaefiling.fincen.treas.gov/main.html Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Designation of Exempt Person	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 31 CFR 1020.315(d)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FinCEN 110	Designation of Exempt Person	DOEP.pdf	http://bsaefiling.fincen.treas.gov/main.html	Yes	Yes	Fillable Fileable Signable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,520	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	27,040	1,880	25,160
Annual IC Time Burden (Hours)	27,040	-4,410	31,450
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.