Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice

Notice of Change of Officials and Senior Executive Officers

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0121 can be found here:

Documents and Forms

Document Name Document Type
Form 4063 Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice Form and Instruction
4063 Notice of Change in Official or Senior Executive Officer NCUA_4063_Notice_of_Change_Official-SrExe_SEP2015(1).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 701.14

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4063	Notice of Change in Official or Senior Executive Officer	NCUA_4063_Notice_of_Change_Official-SrExe_SEP2015(1).pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 219	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	264	-160	424
Annual IC Time Burden (Hours)	446	-402	848
Annual IC Cost Burden (Dollars)	0	-26,763	26,763

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.