Form 1-Z

ICR 201503-3235-020

OMB: 3235-0723

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2015-05-05
Supplementary Document
2014-08-11
IC Document Collections
IC ID
Document
Title
Status
212638
Modified
ICR Details
3235-0723 201503-3235-020
Historical Active 201408-3235-015
SEC CF 270-659
Form 1-Z
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/10/2015
Retrieve Notice of Action (NOA) 05/06/2015
  Inventory as of this Action Requested Previously Approved
06/30/2018 36 Months From Approved
157 0 0
236 0 0
0 0 0

Form 1-Z is used to report terminated or completed offerings or to suspend the duty to file ongoing reports under Regulation A, an exemption under the Securities Act of 1933.

US Code: 15 USC 77c(b), 77s, 77z-3 Name of Law: Securities Act of 1933
   US Code: 15 USC 78l, 78o, 78w(a), 78mm Name of Law: Securities Exchange Act of 1934
   US Code: 15 USC 77ddd Name of Law: Trust Indenture Act of 1939
  
PL: Pub.L. 112 - 106 401 Name of Law: Jumpstart Our Business Startups Act

3235-AL39 Final or interim final rulemaking 80 FR 21806 04/20/2015

No

1
IC Title Form No. Form Name
Form 1-Z

  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 157 0 157 0 0 0
Annual Time Burden (Hours) 236 0 236 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
Form 1-Z is a new collection of information, so there is no change in the burden.

$100,000
No
No
No
No
No
Uncollected
Shehzad Niazi 202 551-3121

  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.
05/06/2015


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