Consumer Response Intake Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
3170-0011 supporting statement.docx	Supporting Statement A	Uploaded 2022-10-05	Repair queued
3170-0011 30-day FRN (published).pdf	Supplementary Document	Uploaded 2022-10-05	Repair queued
3170-0011 60-day FRN (published).pdf	Supplementary Document	Uploaded 2022-10-03	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
198358	Consumer Response Intake Form	Other-collection instruments	Modified

ICR Details

OMB Control No: 3170-0011	ICR Reference No: 202205-3170-001
Status: Historical Active	Previous ICR Reference No: 202204-3170-002
Agency/Subagency: CFPB	Agency Tracking No:
Title: Consumer Response Intake Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/09/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/05/2022
Terms of Clearance: Supporting statement updated during OMB review to reflect public comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	36 Months From Approved	02/28/2023
Responses	2,150,000	0	3,000,000
Time Burden (Hours)	415,000	0	387,500
Cost Burden (Dollars)	0	0	0

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Abstract: The Intake Form is designed to aid the public in the submission of complaints, inquiries, and feedback to the CFPB and to help the CFPB fulfill the aforementioned statutory requirements. Consumers who wish to submit complaints, inquiries, and feedback may submit relevant information using the CFPB’s website where they will find an online version of the Intake Form. Alternatively, they may submit information by telephone and mail using the Intake Form. The Intake Form’s various fields prompt respondents for a description of, and key facts about, their complaints, underlying products and issues, the companies that are the subject of their complaints, and any previous action taken on their complaints. Responses to the Intake Form’s questions help provide the CFPB and the company with the information needed to contact the consumer and/or the consumer’s authorized representative (if applicable), send the complaint to the company for response, and follow-up on the submitted complaint, inquiry, or feedback.

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Authorizing Statute(s): PL: Pub.L. 111 - 203 1021(c)(2); 1022(c); 1013(b)(3 Name of Law: Dodd–Frank Wall Street Reform and Consumer Protection Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 31538	05/24/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 60385	10/05/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Consumer Response Intake Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,150,000	3,000,000	0	0	-850,000	0
Annual Time Burden (Hours)	415,000	387,500	0	27,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The CFPB added 72 net new fields and values representing a new product and sub-products, issues, sub-issues, and data-driven questions. Net new data driven questions are included in “Inventory of Questions” attachment. Net new product, sub-product, issue, and sub-issue fields and values are included in the “Collection Instruments” attachment. The CFPB added four optional fields for the Intake Form: • the consumer’s sex; • the consumer’s race; • whether the consumer is of Hispanic, Latino, or Spanish origin; and • preferred language. The CFPB reduced the estimated annual responses by 850,000 based on updated internal analyses. The reduction in estimated annual responses is not due to programmatic changes to the intake form. The CFPB increased the estimated burden by 27,500 hours (from 387,500 hours to 415,000 hours) over the previous clearance due to the aforementioned revisions which provide respondents more selections to consider. These added fields and values improve the form’s clarity, ease of use, and utility to the Bureau. The Bureau anticipates these additions may increase respondents’ individual research and review burden per response. Please note consumers are not required to answer the four additional fields that capture demographic information. In situations where respondents choose to answer, the fields are expected to be easily answerable and impose a minimal amount of additional burden.

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Annual Cost to Federal Government: $12,067,980

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Yes

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/05/2022

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