Information Collection

Minority Depository Institution Questionnaire

IC 178979 under ICR 200612-3064-004 · OMB 3064-0127.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0127 can be found here:

Documents and Forms

Document Name Document Type
Minority Depository Institution Questionnaire Form
Minority Depository Institution Questionnaire MDI Questionnaire.doc Form
MDI survey request.doc Justification for Minority Depository Institution Questionnaire IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Minority Depository Institution Questionnaire	Agency IC Tracking Number:

IC Status: New

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
Form	none	Minority Depository Institution Questionnaire	MDI Questionnaire.doc	none	No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	100	0	0	0	0	0
Annual IC Time Burden (Hours)	50	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for Minority Depository Institution Questionnaire	MDI survey request.doc	03/09/2007

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