Information Collection

Form 1-SA

IC 212628 under ICR 201408-3235-013 · OMB 3235-0721.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0721 can be found here:

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Information Collection (IC) Details

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IC Title:	Form 1-SA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 239.92

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: 188	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	188	188
Annual IC Time Burden (Hours)	29,952	29,952
Annual IC Cost Burden (Dollars)	2,113,872	2,113,872

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