Information Collection

Reporting Sections 252.14(a)(3)(ii) and 252.14(b)(4)(ii)

IC 218432 under ICR 202410-7100-007 · OMB 7100-0350.

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IC Title:	Reporting Sections 252.14(a)(3)(ii) and 252.14(b)(4)(ii)	Agency IC Tracking Number:	FR YY

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 252.14(a)(3)(ii) 12 CFR 252.14(b)(4)(ii)

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: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	10	-50	60
Annual IC Cost Burden (Dollars)	0	0	0

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