Form 3 - Initial Statement of Beneficial Ownership of Securities

ICR 201409-3235-023

OMB: 3235-0104

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2014-12-11
IC Document Collections
ICR Details
3235-0104 201409-3235-023
Historical Active 201112-3235-006
SEC CF 270-125
Form 3 - Initial Statement of Beneficial Ownership of Securities
Extension without change of a currently approved collection   No
Regular
Approved without change 03/25/2015
Retrieve Notice of Action (NOA) 12/17/2014
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved 03/31/2015
16,855 0 15,400
8,428 0 7,700
0 0 0

Form 3 is an initial statement of beneficial ownership of equity securities required to be filed by officers, directors and ten percent holders of companies with securities registered under Section 12 of the Securities Exchange Act of 1934.

US Code: 15 USC 78l, 78p Name of Law: Securities Exchange Act of 1934
  
None

Not associated with rulemaking

  79 FR 56835 09/23/2014
79 FR 75192 12/17/2014
No

1
IC Title Form No. Form Name
Form 3 - Initial Statement of Beneficial Ownership of Securities SEC 1473 Form 3 - Initial Statement of Beneficial Ownership of Securities

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,855 15,400 0 0 1,455 0
Annual Time Burden (Hours) 8,428 7,700 0 0 728 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The increase in burden of 728 hours is due to an adjustment. The burden hour increase is due to an increase in the number of Form 3 filed with the Commission.

$50,000
No
No
No
No
No
Uncollected
Sean Harrison 202 942-2910

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/17/2014


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