Authorization Agreement for Electronic Funds Transfers Payments

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0135 can be found here:

Documents and Forms

Document Name Document Type
Form ACH Form Authorization Agreement for Electronic Funds Transfers Payments Form
ACH Form Authorizaton Agreeement for Electronic Funds Transfer Pa ACHForm_093006.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Authorization Agreement for Electronic Funds Transfers Payments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ACH Form	Authorizaton Agreeement for Electronic Funds Transfer Payments	ACHForm_093006.pdf		Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 65 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100	-400	500
Annual IC Time Burden (Hours)	25	-100	125
Annual IC Cost Burden (Dollars)	842	-3,368	4,210

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.