OMB control number
U.S. Effects Screening Questionnaire
OMB 3420-0036 ยท OPIC.
OMB 3420-0036
The form is used to conduct a preliminary screen of certain proposed investments or to request prior approval for certain investments made through OPIC-supported Financial Intermediaries that may have potential negative impacts on the U.S. economy or employment.
The latest form for U.S. Effects Screening Questionnaire expires 2021-01-31 and is listed under ICR 201711-3420-003.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form OPIC-252 U.S. Effects Screening Questionnaire | Form and Instruction |
| OPIC-252 Supporting Statement.pdf | Supporting Statement A |
 U.S. Effects Screening Questionnaire |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201711-3420-003 | Revision of a currently approved collection | 2017-11-28 | Approved without change | |
| 201411-3420-004 | New collection (Request for a new OMB Control Number) | 2014-11-13 | Approved with change |