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Federal forms, ICRs, and supporting documents

Information Collection

Application for Debt Education Course Provider

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

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Application for Debt Education Course Provider Form
APPLICATION FOR APPROVAL AS A PROVIDER OF A PERSONAL FINANCIAL MANAGEMENT INSTRUCTIONAL COURSE Application for Debt Education Course Provider Form
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Provider of a Personal Financial Management Instructional Course Application for Debt Education Course Provider Form
Appendix B: Judicial Districts Application for Debt Education Course Provider Form
Appendix C: Business Locations Application for Debt Education Course Provider Form
Appendix D: Matrix of Current Instructors Application for Debt Education Course Provider Form
Appendix E: Activity Report for Approved Providers Application for Debt Education Course Provider Form
Form 2019 Revision 1105
Application for Debt Education Course Provider Application for Debt Education Course Provider		 Form and Instruction
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)

layout table

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 NA Yes Yes Printable Only
Form NA Yes Yes Fillable Printable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Printable
Instruction Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable
Form and Instruction 2019 Revision 1105-0085 Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 147 0 0 0 0 147
Annual IC Time Burden (Hours) 17,288 0 0 0 0 17,288
Annual IC Cost Burden (Dollars) 7,350 0 0 0 0 7,350

Documents for IC
table that charts IC Documents
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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