Information Collection Request

Application for Non-Profit Budget and Credit Counseling Agencies

ICR 201910-1105-002 · OMB 1105-0084 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY Form and Instruction Modified Available
Appendix E: Activity Report for Approved Credit Counseling Agencies Form Modified Available
Appendix D: Matrix of Current Counselors Form Modified Available
Appendix C: Business Locations Form Modified Available
Appendix B: Judicial Districts Form Modified Available
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency Form Modified Available
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY Form Modified Available
11 USC 111.docx Supplementary Document Uploaded 2019-10-16 Repair queued
CC JMD Transmittal Memo.pdf Supplementary Document Uploaded 2019-10-16 Available
JMD Transmittal Memo.pdf Supplementary Document Uploaded 2016-08-31 Available
1105-0084 CC OMB 83-I Submission Form.pdf Supplementary Document Uploaded 2016-08-31 Available
1105-0084_11 USC 111_080713.doc Supplementary Document Uploaded 2013-08-07 Available
CC Supporting Statement Revision 1105-0084.docx Supporting Statement A Uploaded 2019-10-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form and Instruction ModifiedAPPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAppendix E: Activity Report for Approved Credit Counseling Agencies
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAppendix D: Matrix of Current Counselors
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAppendix C: Business Locations
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAppendix B: Judicial Districts
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAppendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency
11781 Application for Non-Profit Budget and Credit Counseling Agencies Form ModifiedAPPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
11781 Application for Non-Profit Budget and Credit Counseling Agencies Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2022 36 Months From Approved 12/31/2019
86 0 122
362 0 560
4,300 0 6,100





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Application for Non-Profit Budget and Credit Counseling Agencies NA, NA, NA, NA, NA, NA, Revision 10.16.2019 1105-0084 ,   ,   ,   ,   ,   ,  

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 86 122 0 -36 0 0
Annual Time Burden (Hours) 362 560 0 -198 0 0
Annual Cost Burden (Dollars) 4,300 6,100 0 -1,800 0 0


Reginfo record details
  No