Certified Statement for Seminannual Deposit Insurance Assessment

Forms and Documents

Document Name	Status
Form 6420-07 Certified Statement for Seminannual Deposit Insurance Assessment Form and Instruction	Modified
2013-21833.pdf Supplementary Document	2013-09-09
SPST 0057 2013 renewal.doc Supporting Statement A	2013-08-28
2013-15974.pdf Supplementary Document	2013-07-03

IC Document Collections

IC ID	Document Title	Status
31803	Certified Statement for Seminannual Deposit Insurance Assessment Form and Instruction	Modified

ICR Details

OMB Control No: 3064-0057	ICR Reference No: 201305-3064-002
Status: Historical Active	Previous ICR Reference No: 201008-3064-004
Agency/Subagency: FDIC	Agency Tracking No:
Title: Certified Statement for Seminannual Deposit Insurance Assessment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/05/2013
	Date Received in OIRA: 09/09/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved	12/31/2013
Responses	27,860	0	15,932
Time Burden (Hours)	9,287	0	5,311
Cost Burden (Dollars)	0	0	0

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Abstract: The FDIC collects the quarterly payments by means of direct debits through the Automated Clearing House network. This information collection consists of statements supported by worksheets and reviewed by officials of the insured institutions to confirm that the assessment data are accurate.

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Authorizing Statute(s): US Code: 12 USC 1817(b) and (c) Name of Law: Federal Deposit Insurance Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 40142	07/03/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 55075	09/09/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Certified Statement for Seminannual Deposit Insurance Assessment	6420-07	Quarterly Certified Statement Invoice

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	27,860	15,932	0	13,930	-2,002	0
Annual Time Burden (Hours)	9,287	5,311	0	4,644	-668	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in burden of 3976 hours, from 5311 hours to 9287 hours, reflects an adjustment of -668 hours resulting from a decrease in the number of insured depository institutions and a program change of +4644 resulting from a correction to the frequency of response from semiannual to quarterly.

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Annual Cost to Federal Government: $2,400

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/09/2013

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