Information Collection

Regulation D Rule 504(b)(3)-Felons and Other Bad Actors Disclosure Statement

IC 221755 under ICR 201612-3235-002 · OMB 3235-0746.

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IC Title:	Regulation D Rule 504(b)(3)-Felons and Other Bad Actors Disclosure Statement	Agency IC Tracking Number:	CF 270-798

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 230.504(b)(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: 8	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	9,600	9,600

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