Information Collection

Application for Debt Education Course Provider

IC 253219 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form May 2022 Application for Debt Education Course Provider	Form and Instruction
Form May 2022 Application for Debt Education Course Provider Application for Debt Education Course Provider	Form and Instruction
May 2022 Application for Debt Education Course Provider OMB 1105-0085 Application Materials.pdf	Form and Instruction
May 2022 Application for Debt Education Course Provider OMB 1105-0085 Application Materials.pdf	Form and Instruction

IC Title:

Application for Debt Education Course Provider

Agency IC Tracking Number:

1105-0085

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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	May 2022	Application for Debt Education Course Provider	OMB 1105-0085 Application Materials.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 135

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	135	135
Annual IC Time Burden (Hours)	10,620	10,620
Annual IC Cost Burden (Dollars)	6,750	6,750

Documents for IC

table that charts IC Documents
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.