Information Collection

Representations

IC 210267 under ICR 201402-3235-001 · OMB 3235-0717.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Representations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 17 CFR 240.3a71-3

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: 300	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 Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	7,500	7,500
Annual IC Cost Burden (Dollars)	200,000	200,000

Documents for IC

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