Information Collection

Reporting Section 201.4(d)(5)(iv)(A)

IC 225771 under ICR 202005-7100-004 · OMB 7100-0373.

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Information Collection (IC) Details

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IC Title:	Reporting Section 201.4(d)(5)(iv)(A)	Agency IC Tracking Number:	FR A

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 201.4(d)(5)(iv)(A)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5	-5	10
Annual IC Time Burden (Hours)	40	-10	50
Annual IC Cost Burden (Dollars)	0	0	0

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