Notification of Changes of Insured Status

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0124 can be found here:

Documents and Forms

Document Name Document Type
2012 SPST 3064-0124.DOC 2012 SPST 3064-0124 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notification of Changes of Insured Status	Agency IC Tracking Number:	3064-0124

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 307

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: Financial Sector Oversight

Privacy Act System of Records
Title: Notification of Changes of Insured Status	FR Citation: 73 FR 62499

Number of Respondents: 291	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	291	6	285
Annual IC Time Burden (Hours)	77	2	75
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
2012 SPST 3064-0124	2012 SPST 3064-0124.DOC	01/31/2012

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