Information Collection

CFPB v Timemark Claims Worksheet

IC 252853 under ICR 202112-3170-003 · OMB 3170-0024.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0024 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CFPB v Timemark Claims Worksheet	Form and Instruction
CFPB v Timemark Claim Worksheet.docx CFPB v Timemark Claim Worksheet.docx	Form and Instruction
CFPB v Timemark Claim Worksheet.docx CFPB v Timemark Claim Worksheet.docx	Form and Instruction
3170-0024 (Timemark) supporting statement.docx 3170-0024 (Timemark) supporting statement.docx	IC Document
3170-0024 (Timemark) supporting statement.docx 3170-0024 (Timemark) supporting statement.docx	IC Document

IC Title:

CFPB v Timemark Claims Worksheet

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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	N/A	CFPB v Timemark Claim Worksheet.docx	CFPB v Timemark Claim Worksheet.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: CFPB.025 Civil Penalty and Bureau-Administered Redress Program Records

FR Citation: 83 FR 23435

Number of Respondents: 7,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,300	7,300
Annual IC Time Burden (Hours)	3,650	3,650
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
3170-0024 (Timemark) supporting statement.docx	3170-0024 (Timemark) supporting statement.docx	04/12/2022

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