Information Collection

Application for Debt Education Course Provider

IC 11783 under ICR 202205-1105-001 · OMB 1105-0085.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0085 can be found here:

Documents and Forms

Document Name Document Type
Application for Debt Education Course Provider Form
2016 DE Application Instructions.docx Instruction
2016 DE Application Instructions.docx Instruction
DE Supplemental Instructions for Universities.docx Instruction
DE Supplemental Instructions for Universities.docx Instruction
APPLICATION FOR APPROVAL AS A PROVIDER OF A PERSONAL FIN 2016 DE Application.docx Form
APPLICATION FOR APPROVAL AS A PROVIDER OF A PERSONAL FIN 2016 DE Application.docx Form
Appendix A: Acknowledgments, Agreements, and Declaration DE Appendix A.doc Form
Appendix A: Acknowledgments, Agreements, and Declaration DE Appendix A.doc Form
Appendix B: Judicial Districts DE Appendix B.docx Form
Appendix B: Judicial Districts DE Appendix B.docx Form
Appendix C: Business Locations DE Appendix C.doc Form
Appendix C: Business Locations DE Appendix C.doc Form
Appendix D: Matrix of Current Instructors DE Appendix D.doc Form
Appendix D: Matrix of Current Instructors DE Appendix D.doc Form
Appendix E: Activity Report for Approved Providers DE Appendix E.docx Form
Appendix E: Activity Report for Approved Providers DE Appendix E.docx Form
2019 Revision 1105 Application for Debt Education Course Provider Revision 2019 1105-0085.pdf Form and Instruction
2019 Revision 1105 Application for Debt Education Course Provider Revision 2019 1105-0085.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Debt Education Course Provider	Agency IC Tracking Number:	1105-0085

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 1320.6

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	APPLICATION FOR APPROVAL AS A PROVIDER OF A PERSONAL FINANCIAL MANAGEMENT INSTRUCTIONAL COURSE	2016 DE Application.docx	Yes	Yes	Printable Only
Form	NA	Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Provider of a Personal Financial Management Instructional Course	DE Appendix A.doc	Yes	Yes	Fillable Printable
Form	NA	Appendix B: Judicial Districts	DE Appendix B.docx	Yes	Yes	Fillable Fileable
Form	NA	Appendix C: Business Locations	DE Appendix C.doc	Yes	Yes	Fillable Fileable
Form	NA	Appendix D: Matrix of Current Instructors	DE Appendix D.doc	Yes	Yes	Fillable Fileable
Form	NA	Appendix E: Activity Report for Approved Providers	DE Appendix E.docx	Yes	Yes	Fillable Printable
Instruction			2016 DE Application Instructions.docx	Yes	Yes	Fillable Fileable
Instruction			DE Supplemental Instructions for Universities.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2019 Revision 1105-0085	Application for Debt Education Course Provider	Revision 2019 1105-0085.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 147	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Previously Approved
Annual Number of Responses for this IC	147	147
Annual IC Time Burden (Hours)	17,288	17,288
Annual IC Cost Burden (Dollars)	7,350	7,350

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.