Information Collection

Disclosure Sections 1005.18(c)(5) and 1005.15(d) Periodic statement alternative one time

IC 237950 under ICR 202201-7100-003 · OMB 7100-0200.

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IC Title:	Disclosure Sections 1005.18(c)(5) and 1005.15(d) Periodic statement alternative one time	Agency IC Tracking Number:	FR E

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1005.15(d) 12 CFR 1005.18(c)(5)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 1

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

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-48	48
Annual IC Time Burden (Hours)	-1,148	1,148
Annual IC Cost Burden (Dollars)	0	0

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