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Forms Relating to Processing Deposit Insurance Claims
Forms Relating to Processing Deposit Insurance Claims
OMB: 3064-0143
IC ID: 31961
OMB.report
FDIC
OMB 3064-0143
ICR 200806-3064-001
IC 31961
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0143 can be found here:
2023-09-26 - Extension without change of a currently approved collection
2022-01-26 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 7200/03
Forms Relating to Processing Deposit Insurance Claims
Form
7200/03 Declaration for Testamentary Deposit
7200-03.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-03.doc
Form
7200/04 Declaration for Public Unit Deposit
7200-04.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-04.doc
Form
7200/05 Declaration for Trust
7200-05.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-05.doc
Form
7200/06 Declaration of Independent Activity
7200-06.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-06.doc
Form
7200/07 Declaration of Independent Activity for Unincorporated A
7200-07.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-07.doc
Form
7200-08 Declaration of Joint Ownership Deposit
7200-08.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-08.doc
Form
7200-09 Declaration for Testamentary Deposit (Multiple Grantors)
7200-09.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-09.doc
Form
7200-10 Declaration for Defined Contribution Plan
7200-10.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-10.doc
Form
7200.11 Declaration for IRA/KEOGH Deposit
7200-11.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-11.doc
Form
7200.12 Declaration for Defined Benefit Plan
7200-12.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-12.doc
Form
7200.13 Declaration of Custodian Deposit
7200-13.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-13.doc
Form
7200.14 Declaration for Health and Welfare Plan
7200-14.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-14.doc
Form
7200-15 Declaration for Plan and Trust
7200-15.doc
fdic01/division/doa/adminservices/records/forms/7000/7200-15.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Forms Relating to Processing Deposit Insurance Claims
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
7200/03
Declaration for Testamentary Deposit
7200-03.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-03.doc
Yes
Yes
Fillable Fileable
Form
7200/04
Declaration for Public Unit Deposit
7200-04.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-04.doc
Yes
Yes
Fillable Fileable
Form
7200/05
Declaration for Trust
7200-05.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-05.doc
Yes
Yes
Fillable Fileable
Form
7200/06
Declaration of Independent Activity
7200-06.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-06.doc
Yes
Yes
Fillable Fileable
Form
7200/07
Declaration of Independent Activity for Unincorporated Association
7200-07.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-07.doc
Yes
Yes
Fillable Fileable
Form
7200-08
Declaration of Joint Ownership Deposit
7200-08.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-08.doc
Yes
Yes
Fillable Fileable
Form
7200-09
Declaration for Testamentary Deposit (Multiple Grantors)
7200-09.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-09.doc
Yes
Yes
Fillable Fileable
Form
7200-10
Declaration for Defined Contribution Plan
7200-10.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-10.doc
Yes
Yes
Fillable Fileable
Form
7200.11
Declaration for IRA/KEOGH Deposit
7200-11.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-11.doc
Yes
Yes
Fillable Fileable
Form
7200.12
Declaration for Defined Benefit Plan
7200-12.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-12.doc
Yes
Yes
Fillable Fileable
Form
7200.13
Declaration of Custodian Deposit
7200-13.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-13.doc
Yes
Yes
Fillable Fileable
Form
7200.14
Declaration for Health and Welfare Plan
7200-14.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-14.doc
Yes
Yes
Fillable Fileable
Form
7200-15
Declaration for Plan and Trust
7200-15.doc
http://fdic01/division/doa/adminservices/records/forms/7000/7200-15.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Financial Sector Oversight
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5,095
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
34 %
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
5,095
0
0
0
0
5,095
Annual IC Time Burden (Hours)
2,875
0
0
0
0
2,875
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.