Information Collection

Certified Statement - Semiannual Assessment Due The Fdic

IC 175525 under ICR 198903-3064-003 · OMB 3064-0057.

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Information Collection (IC) Details

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IC Title:	CERTIFIED STATEMENT - SEMIANNUAL ASSESSMENT DUE THE FDIC	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	6420/10	No	No
Form	FDIC 6420/07	No	No
Form	6420/11	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,750	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	29,500	0	29,500
Annual IC Time Burden (Hours)	29,500	14,750	14,750
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.