Information Collection

Annual Assessment Report

IC 229000 under ICR 202111-1559-002 · OMB 1559-0044.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1559-0044 can be found here:

Documents and Forms

Document Name Document Type
Form 4 Annual Assessment Report Form and Instruction
4 Annual Assessment Report Annual Assessment Criteria with checklist.pdf www.cdfifund.gov/programs-training/Programs/cdfi-bond/Pages/compliance-step.aspx#step5 Form and Instruction
4 Annual Assessment Report Annual Assessment Criteria with checklist.pdf www.cdfifund.gov/programs-training/Programs/cdfi-bond/Pages/compliance-step.aspx#step5 Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Assessment Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 1808

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	Annual Assessment Report	Annual Assessment Criteria with checklist.pdf	https://www.cdfifund.gov/programs-training/Programs/cdfi-bond/Pages/compliance-step.aspx#step5	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40	-26	66
Annual IC Time Burden (Hours)	80	14	66
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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