Information Collection

File Withdrawal Form

IC 199814 under ICR 201110-3235-012 · OMB 3235-0696.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0696 can be found here:

Documents and Forms

Document Name Document Type
Form SBSE-W File Withdrawal Form Form
SBSE-W Form SBSE-W 34-65543-sbse-w.pdf www.sec.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	File Withdrawal Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 249.1601 17 CFR 240.15Fb3-1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SBSE-W	Form SBSE-W	34-65543-sbse-w.pdf	http://www.sec.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.