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Application for Non-Profit Budget and Credit Counseling Agencies
Application for Non-Profit Budget and Credit Counseling Agencies
OMB: 1105-0084
IC ID: 11781
OMB.report
DOJ/LA
OMB 1105-0084
ICR 201202-1105-001
IC 11781
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0084 can be found here:
2022-05-04 - Revision of a currently approved collection
2019-10-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form xxxx
Application for Non-Profit Budget and Credit Counseling Agencies
Form
Credit Counseling Instructions_022212.doc
Instruction
xxxx CC Application Appendix A
CC_Application_Appendix_A.pdf
Form
xxxx CC Application B
CC_Application_Appendix_B.pdf
Form
xxxx CC Appllication C
CC_Application_Appendix_C.pdf
Form
xxxx CC Application Appendix d
CC_Application_Appendix_D.pdf
Form
xxxx CC Application Appendix E
CC_Application_Appendix_E.pdf
Form
OMB Number 1105-00 Credit Counseling Application
Credit Counseling Application_022212.doc
Form
83I OMB.pdf
OMB 83-I
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Non-Profit Budget and Credit Counseling Agencies
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
xxxx
CC Application Appendix A
CC_Application_Appendix_A.pdf
Yes
No
Fillable Printable
Form
xxxx
CC Application B
CC_Application_Appendix_B.pdf
Yes
No
Fillable Printable
Form
xxxx
CC Appllication C
CC_Application_Appendix_C.pdf
Yes
No
Fillable Printable
Form
xxxx
CC Application Appendix d
CC_Application_Appendix_D.pdf
Yes
No
Fillable Printable
Form
xxxx
CC Application Appendix E
CC_Application_Appendix_E.pdf
Yes
No
Fillable Printable
Form
OMB Number 1105-0084
Credit Counseling Application
Credit Counseling Application_022212.doc
Yes
No
Fillable Fileable
Instruction
Credit Counseling Instructions_022212.doc
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Executive Functions
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
300
0
0
0
0
300
Annual IC Time Burden (Hours)
3,000
0
0
0
0
3,000
Annual IC Cost Burden (Dollars)
150,000
0
0
0
0
150,000
Documents for IC
Title
Document
Date Uploaded
OMB 83-I
83I OMB.pdf
06/18/2009
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.