Information Collection

Application for Non-Profit Budget and Credit Counseling Agencies

IC 253221 under ICR 202205-1105-002 · OMB 1105-0084.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0084 can be found here:

Documents and Forms

Document Name Document Type
Form May 2022 Application for Non-Profit Budget and Credit Counseling Agencies Form and Instruction
May 2022 Application for Non-Profit Budget and Credit Counseling OMB 1105-0084 Application Materials.pdf Form and Instruction
May 2022 Application for Non-Profit Budget and Credit Counseling OMB 1105-0084 Application Materials.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Non-Profit Budget and Credit Counseling Agencies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection 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 Non-Profit Budget and Credit Counseling Agencies	OMB 1105-0084 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: 86	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	86	86
Annual IC Time Burden (Hours)	373	373
Annual IC Cost Burden (Dollars)	4,300	4,300

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.