Information Collection

Application for Non-Profit Budget and Credit Counseling Agencies

IC 11781 under ICR 202505-1105-002 · OMB 1105-0084.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Application for Non-Profit Budget and Credit Counseling Agencies Form
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY Application for Non-Profit Budget and Credit Counseling Agencies Form
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency Application for Non-Profit Budget and Credit Counseling Agencies Form
Appendix B: Judicial Districts Application for Non-Profit Budget and Credit Counseling Agencies Form
Appendix C: Business Locations Application for Non-Profit Budget and Credit Counseling Agencies Form
Appendix D: Matrix of Current Counselors Application for Non-Profit Budget and Credit Counseling Agencies Form
Appendix E: Activity Report for Approved Credit Counseling Agencies Application for Non-Profit Budget and Credit Counseling Agencies Form
Form Revision 10.16.201
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY Application for Non-Profit Budget and Credit Counseling Agencies
Form and Instruction
2016 CC Application Instructions.docx Instruction
2016 CC Application Instructions.docx Instruction
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
2016 CC Application.docx
Form
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
2016 CC Application.docx
Form
Appendix A: Acknowledgments, Agreements, and Declaration
CC Appendix A.doc
Form
Appendix A: Acknowledgments, Agreements, and Declaration
CC Appendix A.doc
Form
Appendix B: Judicial Districts
CC Appendix B.docx
Form
Appendix B: Judicial Districts
CC Appendix B.docx
Form
Appendix C: Business Locations
CC Appendix C.doc
Form
Appendix C: Business Locations
CC Appendix C.doc
Form
Appendix D: Matrix of Current Counselors
CC Appendix D.doc
Form
Appendix D: Matrix of Current Counselors
CC Appendix D.doc
Form
Appendix E: Activity Report for Approved Credit Counseli
CC Appendix E.doc
Form
Appendix E: Activity Report for Approved Credit Counseli
CC Appendix E.doc
Form
Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
1105-0084 Collection Instrument.pdf
Form and Instruction
Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
1105-0084 Collection Instrument.pdf
Form and Instruction

Information Collection (IC) Details

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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 NA Yes Yes Printable Only
Form NA Yes Yes Fillable Printable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Fileable
Form NA Yes Yes Fillable Printable
Instruction Yes No Fillable Fileable
Form and Instruction Revision 10.16.2019 1105-0084 Yes No Fillable Printable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 86 0 0 0 0 86
Annual IC Time Burden (Hours) 362 0 0 0 0 362
Annual IC Cost Burden (Dollars) 4,300 0 0 0 0 4,300

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