STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES -- FORM 4

ICR 199403-3235-003

OMB: 3235-0287

Federal Form Document

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ICR Details
3235-0287 199403-3235-003
Historical Active 199102-3235-015
SEC
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES -- FORM 4
Extension without change of a currently approved collection   No
Regular
Approved without change 04/19/1994
Retrieve Notice of Action (NOA) 03/04/1994
  Inventory as of this Action Requested Previously Approved
04/30/1997 04/30/1997 05/31/1994
69,162 0 69,162
34,581 0 34,581
0 0 0

FORM 4 IS REQUIRED TO REPORT TRANSACTIONS OF OFFICERS, DIRECTORS, AND TEN PERCENT SHAREHOLDERS IN THEIR COMPANY'S EQUITY SECURITIES. REGISTERED UNDER SECTION 12 OF THE SECURITIES EXCHANGE ACT OF 1934.

None
None


No

1
IC Title Form No. Form Name
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES -- FORM 4 1474

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 69,162 69,162 0 0 0 0
Annual Time Burden (Hours) 34,581 34,581 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/04/1994


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