FRF Authorization Agreement for Preauthorized Payments Form

Assessment of Fees on Large Bank Holding Companies and Nonbank Financial Companies

Documents and Forms

Document Name Document Type
Form TDF 105.1 FRF Authorization Agreement for Preauthorized Payments Form Form and Instruction
TDF 105.1 Authorization Agreement for Preauthorized Payments TDF 105-1 rev_07-15.pdf Form and Instruction
TDF 105.1 Authorization Agreement for Preauthorized Payments TDF 105-1 rev_07-15.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	FRF Authorization Agreement for Preauthorized Payments Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 150

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TDF 105.1	Authorization Agreement for Preauthorized Payments	TDF 105-1 rev_07-15.pdf		Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	17	-22	39
Annual IC Time Burden (Hours)	4	-6	10
Annual IC Cost Burden (Dollars)	0	0	0

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.