Information Collection Request

Designation of Low Income Status, 12 CFR 701.34(a)

ICR 201804-3133-002 · OMB 3133-0117 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
12CFR701-34_(1-1-18 ED).pdf Supplementary Document Uploaded 2018-09-27 Available
FINAL_3133-0117_Supporting_Statement_092718.docx Supporting Statement A Uploaded 2018-09-27 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214234 Designation of Low-income Status Modified
214233 Appeal of Denial of LID Instruction Removed
214231 Requesting LID outside of examination: Member Address Instruction Removed
208950 Designation of Low Income Status - Sampling Method Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2021 36 Months From Approved 11/30/2018
252 0 502
303 0 772
24,000 0 63,387





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Requesting LID outside of examination: Member Address
Designation of Low-income Status
Appeal of Denial of LID
Designation of Low Income Status - Sampling Method

table that charts list 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 252 502 0 -2 -248 0
Annual Time Burden (Hours) 303 772 0 -48 -421 0
Annual Cost Burden (Dollars) 24,000 63,387 0 -1,488 -37,899 0


Reginfo record details
  No