Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
7200/04 Declaration for Government Deposit Modified 1 1 0 Form and Instruction 7200/04
7200/05 and 7200/27 - Declaration for Trust Account Modified 1 1 0 Form and Instruction 7200/05
Form and Instruction 7200/27
7200/06 Declaration of Independent Activity Modified 1 1 0 Form and Instruction 7200/06
7200/07 Declaration of Independent Activity for Unincorporated Association Modified 1 1 0 Form and Instruction 7200/07
7200/08 Declaration for Joint Ownership Report Modified 1 1 0 Form and Instruction 7200/08
7200/09 Declaration for Testamentary Deposit (In Trust For or Payable on Death) Modified 1 1 0 Form and Instruction 7200/09
7200/10 Declaration for Defined Contribution Plan Modified 1 1 0 Form and Instruction 7200/10
7200/11 Declaration for IRA/KEOGH Deposit Modified 1 1 0 Form and Instruction 7200/11
7200/12 Declaration for defined Benefit Plan Modified 1 1 0 Form and Instruction 7200/12
7200/13 Declaration for Custodian Deposit Modified 1 1 0 Form and Instruction 7200/13
7200/14 Declaration for Health and Welfare Plan Modified 1 1 0 Form and Instruction 7200/14
7200/15 Declaration for Plan and Trust Modified 1 1 0 Form and Instruction 7200/15
7200/18 Declaration for Irrevocable Trust Modified 1 1 0 Form and Instruction 7200/18
7200/24 Claimant Verification Modified 1 1 0 Form and Instruction 7200/24
7200/26 Depositor Interview Modified 1 1 0 Form and Instruction 7200/26
Deposit Broker Submission Checklist Modified 1 0 0
Electronic file on customers, "Broker Input File Requirements" Modified 1 1 0
Exhibit A, Affidavit of Agency Account form Modified 1 5 0
Exhibit B, The standard agency agreement, or the non-standard agency agreement Modified 1 0 0
Total burden requested under this ICR: 19 21 0  
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