Application Pursuant to Section 19 of the Federal Deposit Insurance Act

Forms and Documents

Document Name	Status
Form 6710/07 Application Pursuant to Secton 19 of the Federal Deposit Insurance Act Form and Instruction	Modified
Justification Memo Revision to Form 6710-07.docx Justification for No Material/Nonsubstantive Change	2018-03-09
FR1 - 60-day notice - 81 FR 74802 (Oct 27 2016).pdf Supplementary Document	2017-01-12
FR2 - 30-day notice - 82 FR 3319 (Jan 11 2017).pdf Supplementary Document	2017-01-12
SPST 0018 (2017) Form 6710 (2017).doc Supporting Statement A	2016-12-27
SORNs - 80 FR 66981 (10-30-15).pdf Supplementary Document	2016-12-23

IC Document Collections

IC ID	Document Title	Status
44169	Application Pursuant to Secton 19 of the Federal Deposit Insurance Act Form and Instruction	Modified

ICR Details

OMB Control No: 3064-0018	ICR Reference No: 201803-3064-003
Status: Historical Active	Previous ICR Reference No: 201612-3064-003
Agency/Subagency: FDIC	Agency Tracking No: 3064-0018
Title: Application Pursuant to Section 19 of the Federal Deposit Insurance Act
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/30/2018
	Date Received in OIRA: 03/09/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	06/30/2020	06/30/2020
Responses	75	0	75
Time Burden (Hours)	1,200	0	1,200
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 19 of the Federal Deposit Insurance Act requires insured depository institutions to obtain the FDIC's consent prior to any participation in their affairs by a person convicted of crimes involving dishonesty or breach of trust. Form 6710/07 is the vehicle for requesting FDIC consent, and has been reformatted and rearranged to make it easier to read and understand. The burden per respondent is expected to remain the same at 16 hours.

---

Authorizing Statute(s): US Code: 12 USC 1829 Name of Law: Federal Deposit Insurance Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 74802	10/27/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 3319	01/11/2017
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Application Pursuant to Secton 19 of the Federal Deposit Insurance Act	6710/07	Application Pursuant to Secton 19 of the Federal Deposit Insurance Act

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	75	75	0	0	0	0
Annual Time Burden (Hours)	1,200	1,200	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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

---

Common Form ICR:  No

---

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: 03/09/2018

---