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Consumer Response Intake Form
Consumer Response Intake Form
OMB: 3170-0011
IC ID: 198358
OMB.report
CFPB
OMB 3170-0011
ICR 202304-3170-001
IC 198358
( )
Documents and Forms
Document Name
Document Type
3170-0011 Intake Instruments and Product Subproduct Issue and Subissue Values.docx
Other-collection instruments
3170-0011 Intake Instruments and Product Subproduct Issue and Subissue Values.docx
Other-collection instruments
3170-0011 Inventory of Questions.docx
Other-inventory of questions
3170-0011 Inventory of Questions.docx
Other-inventory of questions
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Consumer Response Intake Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-collection instruments
3170-0011 Intake Instruments and Product Subproduct Issue and Subissue Values.docx
Yes
Yes
Fillable Fileable
Other-inventory of questions
3170-0011 Inventory of Questions.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Financial Sector Oversight
Privacy Act System of Records
Title:
CFPB.005—Consumer Response System
FR Citation:
79 FR 21440
Number of Respondents:
2,150,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
75 %
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
2,150,000
0
0
0
0
2,150,000
Annual IC Time Burden (Hours)
415,000
0
0
0
0
415,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.