Information Collection

Form 15

IC 34486 under ICR 201105-3235-006 · OMB 3235-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0167 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC-2069 Form 15	Form and Instruction
SEC-2069 Form 15 3235-0167.form15.10-31-2013.pdf www.sec.gov/about/forms/form15.pdf	Form and Instruction

IC Title:

Form 15

Agency IC Tracking Number:

CF 270-170

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 249.323

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-2069	Form 15	3235-0167.form15.10-31-2013.pdf	http://www.sec.gov/about/forms/form15.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,042

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
	Requested	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	2,042	-958	3,000
Annual IC Time Burden (Hours)	3,063	-1,437	4,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.