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Federal forms, ICRs, and supporting documents

Information Collection

Certified Statement for Deposit Insurance Assessment

IC 31803 under ICR 202311-3064-006 · OMB 3064-0057.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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Certified Statement for Deposit Insurance Assessment
 
No Modified
 
Required to Obtain or Retain Benefits
 
12 CFR 327

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 6420-07 Quarterly Certified Statement Invoice 6420-07.pdf Yes Yes Fillable Fileable Signable

Economic Development Financial Sector Oversight

 

4,755 3,475
   
Private Sector Businesses or other for-profits
 
   100 %

  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 19,020 0 0 0 0 19,020
Annual IC Time Burden (Hours) 6,340 0 0 0 0 6,340
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Justification Memo for Non-Substantive Change 3064-0057 Justification Memo Non Substantive Revisions 3064-0057 Novemebr 2023.docx 11/30/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.