Information Collection

Diversity Assessment Report

IC 218876 under ICR 202307-3235-005 · OMB 3235-0740.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3235-0740 Diversity Assessment Report	Form and Instruction
3235-0740 Diversity Assessment Form OMWI-Diversity Assessment Report to OMB PRA Extension.pdf	Form and Instruction
3235-0740 Diversity Assessment Form OMWI-Diversity Assessment Report to OMB PRA Extension.pdf	Form and Instruction
3235-0740 Updated Diversity Assessment Form UPDATED OMWI-Diversity Assessment Report to OMB PRA Extension.pdf	Form and Instruction
3235-0740 Updated Diversity Assessment Form UPDATED OMWI-Diversity Assessment Report to OMB PRA Extension.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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	3235-0740	Diversity Assessment Form	OMWI-Diversity Assessment Report to OMB PRA Extension.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	3235-0740	Updated Diversity Assessment Form	UPDATED OMWI-Diversity Assessment Report to OMB PRA Extension.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	1,300	1,300
Annual IC Cost Burden (Dollars)	146,900	146,900

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.