Annual Certification and Data Collection Report Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1559-0046 can be found here:

Documents and Forms

Document Name Document Type
Form 201508 - 2 Annual Certification and Data Collection Report Form Form and Instruction
Instructions - CDFI Fund Annual Certification and Data Collection Report Form.docx Instruction
201508 - 2 Certification Amendment Form Certification Amendment Form.docx Form and Instruction
201508-1 CDFI Fund Annual Certification and Data Collection Repor Form - CDFI Fund Annual Certification and Data Collection Report Form - Revised 20151217.docx Form and Instruction
CDFI Fund Glossary.docx CDFI Fund Glossary IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Certification and Data Collection Report Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	201508 - 2	Certification Amendment Form	Certification Amendment Form.docx	Yes	Yes	Fillable Fileable Signable
Instruction			Instructions - CDFI Fund Annual Certification and Data Collection Report Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	201508-1	CDFI Fund Annual Certification and Data Collection Report Form	Form - CDFI Fund Annual Certification and Data Collection Report Form - Revised 20151217.docx	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 850	Number of Respondents for Small Entity: 50

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	850	850
Annual IC Time Burden (Hours)	6,800	6,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CDFI Fund Glossary	CDFI Fund Glossary.docx	08/24/2015

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