Application for Non-Profit Budget and Credit Counseling Agencies

Forms and Documents

Document	Type	Status	Availability
Form May 2022 Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction	Unchanged	Repair queued
Form May 2022 Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction	Unchanged	Repair queued
Form Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Form and Instruction	Unchanged	Available
Appendix E: Activity Report for Approved Credit Counseling Agencies	Form	Unchanged	Repair queued
Appendix D: Matrix of Current Counselors	Form	Unchanged	Source copy available
Appendix C: Business Locations	Form	Unchanged	Repair queued
Appendix B: Judicial Districts	Form	Unchanged	Repair queued
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency	Form	Unchanged	Repair queued
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Form	Unchanged	Repair queued
Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Repair queued
CC JMD Transmittal Memo 1105-0084.pdf	Supplementary Document	Uploaded 2022-05-04	Repair queued
CC JMD Transmittal Memo 1105-0084.pdf	Supplementary Document	Uploaded 2022-05-04	Repair queued
11 USC 111.docx	Supplementary Document	Uploaded 2019-10-16	Repair queued
11 USC 111.docx	Supplementary Document	Uploaded 2019-10-16	Repair queued
CC JMD Transmittal Memo.pdf	Supplementary Document	Uploaded 2019-10-16	Repair queued
CC JMD Transmittal Memo.pdf	Supplementary Document	Uploaded 2019-10-16	Repair queued
JMD Transmittal Memo.pdf	Supplementary Document	Uploaded 2016-08-31	Available
JMD Transmittal Memo.pdf	Supplementary Document	Uploaded 2016-08-31	Repair queued
1105-0084 CC OMB 83-I Submission Form.pdf	Supplementary Document	Uploaded 2016-08-31	Repair queued
1105-0084 CC OMB 83-I Submission Form.pdf	Supplementary Document	Uploaded 2016-08-31	Repair queued
1105-0084_11 USC 111_080713.doc	Supplementary Document	Uploaded 2013-08-07	Repair queued
1105-0084_11 USC 111_080713.doc	Supplementary Document	Uploaded 2013-08-07	Repair queued
CC Supporting Statement A.docx	Supporting Statement A	Uploaded 2025-09-12	Repair queued
OMB 1105-0084 Application Materials.pdf	Supporting Statement A	Uploaded 2022-05-04	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
253221	Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction	Unchanged	Application for Non-Profit Budget and Credit Counseling Agencies
253221	Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction	Unchanged
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction	Unchanged	APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Appendix E: Activity Report for Approved Credit Counseling Agencies
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Appendix D: Matrix of Current Counselors
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Appendix C: Business Locations
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Appendix B: Judicial Districts
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged	APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Form	Unchanged
11781	Application for Non-Profit Budget and Credit Counseling Agencies	Instruction	Unchanged

ICR Details

OMB Control No: 1105-0084	ICR Reference No: 202505-1105-002
Status: Active	Previous ICR Reference No: 202205-1105-002
Agency/Subagency: DOJ/LA	Agency Tracking No: 1105-0084
Title: Application for Non-Profit Budget and Credit Counseling Agencies
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/23/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/08/2025
Terms of Clearance: In accordance with 5 CFR 1320, this information collection is approved

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2028	36 Months From Approved	09/30/2025
Responses	172	0	172
Time Burden (Hours)	735	0	735
Cost Burden (Dollars)	8,600	0	8,600

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Abstract: Under the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 (Act), Pub.L. 109-8, the United States Trustee (UST) is charged with creating an approved list of credit counseling agencies. Each agency must meet minimum qualifications established by Congress in the new law. The UST needs the information in the application in order to evaluate whether the applicants meet these qualifications established by Congress. The respondents to the application will be credit counseling agencies who seek to counsel individuals before they file for bankruptcy.

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Authorizing Statute(s): PL: Pub.L. 109 - 8 106 Name of Law: Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 (Act)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 22326	05/27/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 38509	08/08/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Application for Non-Profit Budget and Credit Counseling Agencies	May 2022	Application for Non-Profit Budget and Credit Counseling Agencies
Application for Non-Profit Budget and Credit Counseling Agencies	NA, NA, NA, NA, NA, NA, Revision 10.16.2019 1105-0084	APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY ,   Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency ,   Appendix B: Judicial Districts ,   Appendix C: Business Locations ,   Appendix D: Matrix of Current Counselors ,   Appendix E: Activity Report for Approved Credit Counseling Agencies ,   APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	172	172	0	0	0	0
Annual Time Burden (Hours)	735	735	0	0	0	0
Annual Cost Burden (Dollars)	8,600	8,600	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $561,661

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/08/2025

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