OMB control number

Application for Non-Profit Budget and Credit Counseling Agencies

OMB 1105-0084 · DOJ/LA.

OMB 1105-0084

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.

The latest form for Application for Non-Profit Budget and Credit Counseling Agencies expires 2028-09-30 and is listed under ICR 202505-1105-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form May 2022 Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction
Form May 2022 Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction
Form Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Form and Instruction
Appendix E: Activity Report for Approved Credit Counseling Agencies	Form
Appendix D: Matrix of Current Counselors	Form
Appendix C: Business Locations	Form
Appendix B: Judicial Districts	Form
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency	Form
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
CC JMD Transmittal Memo 1105-0084.pdf	Supplementary Document
CC JMD Transmittal Memo 1105-0084.pdf	Supplementary Document
11 USC 111.docx	Supplementary Document
11 USC 111.docx	Supplementary Document
CC JMD Transmittal Memo.pdf	Supplementary Document
CC JMD Transmittal Memo.pdf	Supplementary Document
JMD Transmittal Memo.pdf	Supplementary Document
JMD Transmittal Memo.pdf	Supplementary Document
1105-0084 CC OMB 83-I Submission Form.pdf	Supplementary Document
1105-0084 CC OMB 83-I Submission Form.pdf	Supplementary Document
1105-0084_11 USC 111_080713.doc	Supplementary Document
1105-0084_11 USC 111_080713.doc	Supplementary Document
CC Supporting Statement A.docx	Supporting Statement A
OMB 1105-0084 Application Materials.pdf	Supporting Statement A
Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction
Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction
Application for Non-Profit Budget and Credit Counseling Agencies	Form and Instruction
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Form
Application for Non-Profit Budget and Credit Counseling Agencies	Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202505-1105-002	Revision of a currently approved collection	2025-08-08
202205-1105-002	Revision of a currently approved collection	2022-05-04	Approved without change
201910-1105-002	Revision of a currently approved collection	2019-10-16	Approved without change
201604-1105-002	Revision of a currently approved collection	2016-09-14	Approved without change
201308-1105-001	Revision of a currently approved collection	2013-08-07	Approved without change
201303-1105-001	No material or nonsubstantive change to a currently approved collection	2013-03-05	Approved without change
201208-1105-001	Extension without change of a currently approved collection	2012-08-22	Approved without change
201202-1105-001	No material or nonsubstantive change to a currently approved collection	2012-02-22	Approved without change
200906-1105-002	Extension without change of a currently approved collection	2009-06-25	Approved with change
200701-1105-001	No material or nonsubstantive change to a currently approved collection	2007-01-25	Approved with change
200601-1105-002	Revision of a currently approved collection	2006-01-12	Approved with change
200506-1105-001	New collection (Request for a new OMB Control Number)	2005-06-14	Approved with change

OMB Details

Application for Non-Profit Budget and Credit Counseling Agencies

Federal Enterprise Architecture: General Government - Executive Functions

Information collection instruments
Form	Name	Electronic access	Type
Form NA	Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency	Fillable Printable	Form
Form Revision 10.16.2019 1105-0084	APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Fillable Printable	Form and instruction
Form NA	APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY	Printable Only	Form
Form NA	Appendix E: Activity Report for Approved Credit Counseling Agencies	Fillable Printable	Form
Form NA	Appendix D: Matrix of Current Counselors	Fillable Fileable	Form
Form NA	Appendix C: Business Locations	Fillable Fileable	Form
Form NA	Appendix B: Judicial Districts	Fillable Fileable	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.