Information Collection

Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Manag. Invest. Companies

IC 43001 under ICR 200912-3235-004 · OMB 3235-0316.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0316 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC-2124 Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Manag. Invest. Companies	Form and Instruction
SEC-2124 Form N-3 SEC2124formn-3.pdf www.sec.gov/about/forms/formn-3.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Manag. Invest. Companies

Agency IC Tracking Number:

IM-270-281

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 239.17a 17 CFR 274.11b

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 and Instruction	SEC-2124	Form N-3	SEC2124formn-3.pdf	http://www.sec.gov/about/forms/formn-3.pdf	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:

FR Citation:

Number of Respondents: 17

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	17	-15	32
Annual IC Time Burden (Hours)	13,011	38	12,973
Annual IC Cost Burden (Dollars)	586,100	45,900	540,200

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.