Information Collection

Disclosures

IC 192051 under ICR 202605-3084-001 · OMB 3084-0157.

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Information Collection (IC) Details

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IC Title:	Disclosures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1015

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: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 70

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

Percentage of Respondents Reporting Electronically: 55 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	120	2	118
Annual IC Time Burden (Hours)	360	6	354
Annual IC Cost Burden (Dollars)	33,000	0	33,000

Documents for IC

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

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