Information Collection

Form 3 - Initial Statement of Beneficial Ownership of Securities

IC 34357 under ICR 201409-3235-023 · OMB 3235-0104.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0104 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
form3datainstructions.12-31-2014.pdf www.sec.gov/about/forms/form3data.pdf	Instruction
SEC 1473 Form 3 - Initial Statement of Beneficial Ownership of Se form3.12-31-2014.pdf www.sec.gov/about/forms/form3.pdf	Form
EDGAR PIA_Redacted.pdf EDGAR PIA REDACTED	IC Document
secsorn5.pdf SEC SORN 5	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Form 3 - Initial Statement of Beneficial Ownership of Securities

Agency IC Tracking Number:

CF 270-125

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 249.103

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
Instruction			form3datainstructions.12-31-2014.pdf	http://www.sec.gov/about/forms/form3data.pdf	Yes	Yes	Fillable Fileable
Form	SEC 1473	Form 3 - Initial Statement of Beneficial Ownership of Securities	form3.12-31-2014.pdf	http://www.sec.gov/about/forms/form3.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: (SEC 5) Ownership Reports and Insider Trading Transaction Records Filed under the Securities Exchange Act of 1934, Public Utility Holding Company Act of 1935, and Investment Company Act of 1940 --SEC

FR Citation: 41 FR 41550

Number of Respondents: 16,855

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
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	16,855	1,455	15,400
Annual IC Time Burden (Hours)	8,428	728	7,700
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
EDGAR PIA REDACTED	EDGAR PIA_Redacted.pdf	12/17/2014
SEC SORN 5	secsorn5.pdf	12/17/2014

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