View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1559-0046	ICR Reference No: 201708-1559-001
Status: Historical Inactive	Previous ICR Reference No: 201506-1559-006
Agency/Subagency: TREAS/CDFIF	Agency Tracking No:
Title: Annual Certification and Data Collection Report Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 04/29/2019
	Date Received in OIRA: 10/19/2018
Terms of Clearance: CDFI is reconsidering this report form and will resubmit this ICR once it has finalized its plans for this reporting requirement.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved	04/30/2019
Responses	850	0	850
Time Burden (Hours)	6,800	0	6,800
Cost Burden (Dollars)	0	0	0

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Chris Stever 2026228322 steverc@cdfi.treas.gov

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