Information Collection

Uniform Application for Municipal Securities Principal or Representative

IC 230575 under ICR 202102-3064-010 · OMB 3064-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0022 can be found here:

2024-04-24 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FDIC 6200-54 Revis Uniform Application for Municipal Securities Principal or Representative	Form
Form FDIC 6200-54 Revis Form MSD-4 Uniform Application for Municipal Securities Principal or Municipal Securities Representative Associated With a Bank Municipal Securities Dealer Uniform Application for Municipal Securities Principal or Representative	Form
6200-54i (Ext) - MSD-4 Instructions (8-18).pdf	Instruction
6200-54i (Ext) - MSD-4 Instructions (8-18).pdf	Instruction
FDIC 6200-54 Revis Form MSD-4 Uniform Application for Municipal Securities 6200-54r (8-18).pdf	Form
FDIC 6200-54 Revis Form MSD-4 Uniform Application for Municipal Securities 6200-54r (8-18).pdf	Form
MSD-4 Redline.pdf Interagency Form MSD-4 Revsisions Redlined	IC Document
MSD-4 Redline.pdf Interagency Form MSD-4 Revsisions Redlined	IC Document
Justification Memo 0022 - Uniform Application - Termination Municipal Securities.docx Justification Memo 0022 Uniform Application and Termination Notice Municipal Securities	IC Document
Justification Memo 0022 - Uniform Application - Termination Municipal Securities.docx Justification Memo 0022 Uniform Application and Termination Notice Municipal Securities	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Uniform Application for Municipal Securities Principal or Representative

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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
Form	FDIC 6200-54 Revised August 2018				Yes	Yes	Fillable Fileable
Instruction					Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: Professional Qualification Records for Municipal Securities Dealers, Municipal Securities Representatives, and U.S. Government Securities Brokers/Dealers System of Records (30-64-0016)

FR Citation: 80 FR 66982

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Interagency Form MSD-4 Revsisions Redlined		12/06/2018
Justification Memo 0022 Uniform Application and Termination Notice Municipal Securities		12/06/2018

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

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