Download:
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pdf Collect Registration Form
The Bureau of Consumer Financial Protection’s Collect website allows financial institutions
to respond to the semi-annual Terms of Credit Card Plans (TCCP) Survey. Please complete
and submit this form to the Collect Support Team to establish a point of contact (POC) for
your company. The POC will then be able to submit TCCP Surveys to the Bureau and create
additional profiles for other employees of your financial institution to submit TCCP Surveys.
For questions concerning this form, please contact the Collect Support Team at
Collect_Support@cfpb.gov.
Company information
1
2
Please provide your
company’s name
and headquarters
location.
COMPANY NAME
Please provide
your company’s
identification
numbers. You must
provide at least one.
LEI
CITY (HEADQUARTERS)
RSSD ID
STATE
TAX ID (TIN)
Contact information
3
Please provide the
name and contact
information for the
individual who will
be your financial
institution’s POC.
FIRST NAME
LAST NAME
POSITION TITLE
WORK EMAIL ADDRESS
WORK PHONE
ALTERNATE WORK PHONE (OPTIONAL)
Submission instructions
To submit this form, please email it to Collect_Support@cfpb.gov.
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Privacy Act Statement
The information you provide will permit the Bureau to process your request or inquiry so you may access a
system or interact with a Bureau information technology system. Information about your request or inquiry
(including your personally identifiable information) may be shared pursuant to the CFPB’s published Privacy
Act system of records notice CFPB.014 Direct Registration and User Management System. This collection of
information is authorized by 12 U.S.C. § 5492. Failure to provide the requested information may prevent the
Bureau from granting you direct access to this system.
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a valid OMB control number. The OMB control number for this collection is 3170-0001. It
expires on XX/XX/XXXX. The time required to complete this information collection in its entirety is estimated to average 1 minute per
response. The obligation to respond to this collection of information is voluntary, however, is required in order to register to use the
Collect system. Comments regarding this collection of information, including the estimated response time, suggestions for improving
the usefulness of the information, or suggestions for reducing the burden to respond to this collection should be submitted to Consumer
Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
PRA_Comments@cfpb.gov.
2 of 2
Collect Registration Form
The Bureau of Consumer Financial Protection’s Collect website allows financial institutions
to respond to the semi-annual Terms of Credit Card Plans (TCCP) Survey. Please complete
and submit this form to the Collect Support Team to establish a point of contact (POC) for
your company. The POC will then be able to submit TCCP Surveys to the Bureau and create
additional profiles for other employees of your financial institution to submit TCCP Surveys.
For questions and submission
For questions or to submit this form, please email the Collect Support Team at
Collect_Support@cfpb.gov.
Privacy Act Statement
The information you provide will permit the Bureau to process your request or inquiry so you may access a
system or interact with a Bureau information technology system. Information about your request or inquiry
(including your personally identifiable information) may be shared pursuant to the CFPB’s published Privacy
Act system of records notice CFPB.014 Direct Registration and User Management System. This collection of
information is authorized by 12 U.S.C. § 5492. Failure to provide the requested information may prevent the
Bureau from granting you direct access to this system.
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to
a collection of information unless it displays a valid OMB control number. The OMB control number for this collection is 3170-0001.
It expires on XX/XX/XXXX. The time required to complete this information collection in its entirety is estimated to average 1 minute
per response. The obligation to respond to this collection of information is voluntary, however, is required in order to register to use
the Collect system. Comments regarding this collection of information, including the estimated response time, suggestions for
improving the usefulness of the information, or suggestions for reducing the burden to respond to this collection should be submitted
to Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
PRA_Comments@cfpb.gov.
1 of 2
Company information
1
2
Please provide your
company’s name
and headquarters
location.
COMPANY NAME
Please provide
your company’s
identification
numbers. You must
provide at least one.
LEI
CITY (HEADQUARTERS)
RSSD ID
STATE
TAX ID (TIN)
Contact information
3
Please provide the
name and contact
information for the
individual who will
be your financial
institution’s POC.
FIRST NAME
LAST NAME
POSITION TITLE
WORK EMAIL ADDRESS
WORK PHONE
ALTERNATE WORK PHONE (OPTIONAL)
2 of 2
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |