Information Collection

Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice

IC 32746 under ICR 202109-3133-002 · OMB 3133-0121.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0121 can be found here:

Documents and Forms

Document Name Document Type
Form 4063 Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice Form and Instruction
4063 Notice of Change in Official or Senior Executive Officer NCUA_4063_Notice_of_Change_Official-SrExe_SEP2015(1).pdf Form and Instruction
4063 Notice of Change in Official or Senior Executive Officer NCUA_4063_Notice_of_Change_Official-SrExe_SEP2015(1).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 4063 - Notice of Change In Official or Senior Executive Officer; Waiver to Notice	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 701.14

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4063	Notice of Change in Official or Senior Executive Officer	NCUA_4063_Notice_of_Change_Official-SrExe_SEP2015(1).pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 183	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	271	7	264
Annual IC Time Burden (Hours)	393	-53	446
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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