Information Collection

Rule 147A(f)(1)(iii) Written Representation as to Purchaser Residency

IC 225143 under ICR 201701-3235-006 · OMB 3235-0757.

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Information Collection (IC) Details

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IC Title:	Rule 147A(f)(1)(iii) Written Representation as to Purchaser Residency	Agency IC Tracking Number:	CF 270-806

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 230.147A(f)(1)(iii)

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: 700	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	1,925	1,925
Annual IC Cost Burden (Dollars)	70,000	70,000

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