Information Collection

Proof of Concept

IC 235499 under ICR 201903-3133-003 · OMB 3133-0202.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0202 can be found here:

Documents and Forms

Document Name Document Type
POC_All_Screen_Shots_5-15-19.pdf Other-Screen Shots-Web-based Applica
2019 Final Proof of Concept Application Instructions 5-15-19.pdf Proof of Concept Application Instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Proof of Concept	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 701 Apx B

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shots-Web-based Application			POC_All_Screen_Shots_5-15-19.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: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Proof of Concept Application Instructions	2019 Final Proof of Concept Application Instructions 5-15-19.pdf	05/23/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.