Information Collection

Application Pursuant to Secton 19 of the Federal Deposit Insurance Act

IC 44169 under ICR 202108-3064-002 · OMB 3064-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0018 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6710-07 Application Pursuant to Secton 19 of the Federal Deposit Insurance Act	Form and Instruction
6710-07 FDIC Application Pursuant to Section 19 of the FDI Act 6710-07; 20210805 (R).pdf	Form and Instruction
6710-07 FDIC Application Pursuant to Section 19 of the FDI Act f6710-07.pdf	Form and Instruction
6710-07; 20210804 Compare Requested Edits to Current Form.docx Compare version of Form 6710-07 Showing NS Revisions	IC Document
6710-07; 20210804 Compare Requested Edits to Current Form.docx Compare version of Form 6710-07 Showing NS Revisions	IC Document
Justification Memo 2021 NS Revision to Form 6710-07.docx Justification Memo NS Revisions to Form 6710-07	IC Document
Justification Memo 2021 NS Revision to Form 6710-07.docx Justification Memo NS Revisions to Form 6710-07	IC Document

IC Title:

Application Pursuant to Secton 19 of the Federal Deposit Insurance Act

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	6710-07	FDIC Application Pursuant to Section 19 of the FDI Act	f6710-07.pdf		Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: FDIC-30--64--0002: Financial Institution Investigative and Enforcement Records.

FR Citation: 80 FR 66981

Number of Respondents: 54

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	54	54
Annual IC Time Burden (Hours)	864	864
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Compare version of Form 6710-07 Showing NS Revisions	6710-07; 20210804 Compare Requested Edits to Current Form.docx	08/09/2021
Justification Memo NS Revisions to Form 6710-07	Justification Memo 2021 NS Revision to Form 6710-07.docx	08/09/2021

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