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Application for Non-Profit Budget and Credit Counseling Agencies
Application for Non-Profit Budget and Credit Counseling Agencies
OMB: 1105-0084
IC ID: 11781
OMB.report
DOJ/LA
OMB 1105-0084
ICR 202205-1105-002
IC 11781
( )
Documents and Forms
Document Name
Document Type
Application for Non-Profit Budget and Credit Counseling Agencies
Form
2016 CC Application Instructions.docx
Instruction
2016 CC Application Instructions.docx
Instruction
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
2016 CC Application.docx
Form
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
2016 CC Application.docx
Form
Appendix A: Acknowledgments, Agreements, and Declaration
CC Appendix A.doc
Form
Appendix A: Acknowledgments, Agreements, and Declaration
CC Appendix A.doc
Form
Appendix B: Judicial Districts
CC Appendix B.docx
Form
Appendix B: Judicial Districts
CC Appendix B.docx
Form
Appendix C: Business Locations
CC Appendix C.doc
Form
Appendix C: Business Locations
CC Appendix C.doc
Form
Appendix D: Matrix of Current Counselors
CC Appendix D.doc
Form
Appendix D: Matrix of Current Counselors
CC Appendix D.doc
Form
Appendix E: Activity Report for Approved Credit Counseli
CC Appendix E.doc
Form
Appendix E: Activity Report for Approved Credit Counseli
CC Appendix E.doc
Form
Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
1105-0084 Collection Instrument.pdf
Form and Instruction
Revision 10.16.201 APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDI
1105-0084 Collection Instrument.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Non-Profit Budget and Credit Counseling Agencies
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
NA
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
2016 CC Application.docx
Yes
Yes
Printable Only
Form
NA
Appendix A: Acknowledgments, Agreements, and Declarations in Support of Application for Approval as a Nonprofit Budget and Credit Counseling Agency
CC Appendix A.doc
Yes
Yes
Fillable Printable
Form
NA
Appendix B: Judicial Districts
CC Appendix B.docx
Yes
Yes
Fillable Fileable
Form
NA
Appendix C: Business Locations
CC Appendix C.doc
Yes
Yes
Fillable Fileable
Form
NA
Appendix D: Matrix of Current Counselors
CC Appendix D.doc
Yes
Yes
Fillable Fileable
Form
NA
Appendix E: Activity Report for Approved Credit Counseling Agencies
CC Appendix E.doc
Yes
Yes
Fillable Printable
Instruction
2016 CC Application Instructions.docx
Yes
No
Fillable Fileable
Form and Instruction
Revision 10.16.2019 1105-0084
APPLICATION FOR APPROVAL AS A NONPROFIT BUDGET AND CREDIT COUNSELING AGENCY
1105-0084 Collection Instrument.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Executive Functions
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
86
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
86
0
0
0
0
86
Annual IC Time Burden (Hours)
362
0
0
0
0
362
Annual IC Cost Burden (Dollars)
4,300
0
0
0
0
4,300
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.