Information Collection

Application Pursuant to Secton 19 of the Federal Deposit Insurance Act

IC 44169 under ICR 202110-3064-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 f6710-07.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: 73

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	73	19	54
Annual IC Time Burden (Hours)	1,168	304	864
Annual IC Cost Burden (Dollars)	0	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.