Information Collection

Rule 71 [17 CFR 250] Statements to be Filed Pursuant to Section 12(i). Form U-12(1)-A, Form U-12(1)-B

IC 34495 under ICR 200410-3235-010 · OMB 3235-0173.

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IC Title:

Rule 71 [17 CFR 250] Statements to be Filed Pursuant to Section 12(i). Form U-12(1)-A, Form U-12(1)-B

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1381				Yes	Yes
Form	979				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

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