Information Collection

Disclosures (Section 1041.9)

IC 263946 under ICR 202309-3170-003 · OMB 3170-0071.

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IC Title:	Disclosures (Section 1041.9)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1041

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,045	Number of Respondents for Small Entity: 9,045

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	231,732,981	231,732,981
Annual IC Time Burden (Hours)	3,012,529	3,012,529
Annual IC Cost Burden (Dollars)	11,586,649	11,586,649

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