Consumer Response Intake Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
3170-0011 Analytical_Mapping_File_Debanking update (002).xlsx	Supplementary Document	Uploaded 2026-10-21	Available
3170-0011 Non_Substantive_Change_Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-10-21	Available
3170-0011 supporting statement.docx	Supporting Statement A	Uploaded 2026-02-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
198358	Consumer Response Intake Form	Other-Collection Instruments	Unchanged

ICR Details

OMB Control No: 3170-0011	ICR Reference No: 202610-3170-001
Status: Received in OIRA	Previous ICR Reference No: 202511-3170-001
Agency/Subagency: CFPB	Agency Tracking No:
Title: Consumer Response Intake Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/21/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	03/31/2029	03/31/2029
Responses	6,000,000	6,000,000
Time Burden (Hours)	1,123,334	1,123,334
Cost Burden (Dollars)	0	0

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Abstract: The Intake Form is designed to aid the public in the submission of complaints, inquiries, and feedback to the CFPB and to help the CFPB fulfill the aforementioned statutory requirements. Consumers who wish to submit complaints, inquiries, and feedback may submit relevant information using the CFPB’s website where they will find an online version of the Intake Form. Alternatively, they may submit information by telephone and mail using the Intake Form. The Intake Form’s various fields prompt respondents for a description of, and key facts about, their complaints, underlying products and issues, the companies that are the subject of their complaints, and any previous action taken on their complaints. Responses to the Intake Form’s questions help provide the CFPB and the company with the information needed to contact the consumer and/or the consumer’s authorized representative (if applicable), send the complaint to the company for response, and follow-up on the submitted complaint, inquiry, or feedback.

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Authorizing Statute(s): PL: Pub.L. 111 - 203 1021(c)(2); 1022(c); 1013(b)(3 Name of Law: Dodd–Frank Wall Street Reform and Consumer Protection 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 54643	11/28/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 4066	01/30/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Consumer Response Intake Form

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	6,000,000	6,000,000	0	0	0	0
Annual Time Burden (Hours)	1,123,334	1,123,334	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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: The Bureau is considering adding four questions to improve complaint intake. Item 13 adds a 'Whistleblower' option for individuals submitting complaints about company practices that should not be forwarded to the company. This change will enhance the Bureau’s ability to safeguard protected disclosures. Item 19 adds four questions capturing whether consumers contacted consumer reporting agencies and what, if any, responses they received. These changes will enhance the Bureau’s ability to implement Section 611(e) of the Fair Credit Reporting Act (FCRA), which requires the Bureau to collect information about certain complaints. In addition, they are intended to enhance the efficiency of the complaint system by enabling better idenfication of prior FCRA disputes. Beginning in early 2020, the CFPB has experienced a precipitous increase in consumer complaints—from approximately 540,000 complaints in 2020 to 3.18M in 2024. While the program itself is unchanged and in anticipation of continued year over year increases in line with recent years, the program expects to see significant increases in the number of respondents.

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Annual Cost to Federal Government: $16,800,000

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]? Yes

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: 10/21/2026

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