Information Collection

Rule 17a-12; Reporting Requirements for OTC Derivatives Dealers.

IC 35256 under ICR 201001-3235-007 · OMB 3235-0498.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0498 can be found here:

Documents and Forms

Document Name Document Type
formx-17a-5_2b.pdf Form X 17a-5 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rule 17a-12; Reporting Requirements for OTC Derivatives Dealers.	Agency IC Tracking Number:	270-442

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.17a-12

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25	-5	30
Annual IC Time Burden (Hours)	900	-180	1,080
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Form X 17a-5	formx-17a-5_2b.pdf	01/14/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.