Information Collection

Proof of Concept

IC 235499 under ICR 202206-3133-002 · OMB 3133-0202.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
POC New_Redacted_June2022.pdf	Other-Screen Shot - Web-based Applic
POC New_Redacted_June2022.pdf	Other-Screen Shot - Web-based Applic
POC Application Instructions - Final.pdf POC Application Instruction June 2022	IC Document
POC Application Instructions - Final.pdf POC Application Instruction June 2022	IC Document
New POC Questions_June22.docx New POC Questions June 2022	IC Document
New POC Questions_June22.docx New POC Questions June 2022	IC Document

IC Title:

Proof of Concept

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 701 Apx B

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
Other-Screen Shot - Web-based Application			POC New_Redacted_June2022.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 26

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	26	2	24
Annual IC Time Burden (Hours)	104	8	96
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
POC Application Instruction June 2022	POC Application Instructions - Final.pdf	06/30/2022
New POC Questions June 2022	New POC Questions_June22.docx	06/30/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.