Information Collection

Application Forms

IC 222949 under ICR 202001-3170-001 · OMB 3170-0068.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0068 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
3170-0068 Tax Time Savings Application Form - OMB.pdf	Other-Application
3170-0068 Updated YMYG application OMB.pdf	Other-Application

IC Title:

Application Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application			3170-0068 Tax Time Savings Application Form - OMB.pdf		Yes	Yes	Fillable Fileable
Other-Application			3170-0068 Updated YMYG application OMB.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB.021 CFPB Consumer Education and Engagement Records, 77 F.R. 60382

FR Citation: 83 FR 23435

Number of Respondents: 275

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	275	-50	0	325
Annual IC Time Burden (Hours)	825	-250	-550	1,625
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
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.