Information Collection

Consumer Response Intake Form

IC 198358 under ICR 202511-3170-001 · OMB 3170-0011.

Documents and Forms

Document Name Document Type
3170-0011 Intake Instruments and Product Subproduct Issue and Subissue Values.docx Other-Collection Instruments
3170-0011 Inventory of Questions.docx Other-Inventory of Questions

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Response Intake Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Collection Instruments			3170-0011 Intake Instruments and Product Subproduct Issue and Subissue Values.docx		Yes	Yes	Fillable Fileable
Other-Inventory of Questions			3170-0011 Inventory of Questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title: CFPB.005âConsumer Response System	FR Citation: 79 FR 21440

Number of Respondents: 6,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,000,000	3,850,000	2,150,000
Annual IC Time Burden (Hours)	1,123,334	708,334	415,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.

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