Payroll Disclosures

Electronic Fund Transfer Act (Regulation E) 12 CFR 1005

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0014 can be found here:

Documents and Forms

Document Name Document Type
A-30 Form 1.11.12.doc Other-Model Form

Information Collection (IC) Details

IC Title:	Payroll Disclosures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 12 CFR 1005

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Model Form			A-30 Form 1.11.12.doc		No		Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600,000	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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	600,000	0	600,000
Annual IC Time Burden (Hours)	900,000	0	900,000
Annual IC Cost Burden (Dollars)	0	-6,000,000	6,000,000

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.