Information Collection

Credit Card Payment Form

IC 222847 under ICR 202304-1110-004 · OMB 1110-0070.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1-786 Credit Card Payment Form	Form and Instruction
1-786 Credit Card Payment Form 1-786 CC Form.docx	Form and Instruction
1-786 Credit Card Payment Form 1-786 CC Form.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

1-786

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 28 CFR 16

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	1-786	Credit Card Payment Form	1-786 CC Form.docx		No		Paper Only

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records

Title: The FBI Central Records System

FR Citation: 82 FR 24147

Number of Respondents: 28,039

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	28,039	-51,961	80,000
Annual IC Time Burden (Hours)	935	-1,732	2,667
Annual IC Cost Burden (Dollars)	504,702	504,702	0

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.