Exchange Act Form 10

ICR 201705-3235-012

OMB: 3235-0064

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2017-05-26
Supplementary Document
2017-05-25
IC Document Collections
IC ID
Document
Title
Status
34221 Modified
ICR Details
3235-0064 201705-3235-012
Historical Active 201312-3235-021
SEC CF 270-51
Exchange Act Form 10
Extension without change of a currently approved collection   No
Regular
Approved without change 08/10/2017
Retrieve Notice of Action (NOA) 05/30/2017
  Inventory as of this Action Requested Previously Approved
08/31/2020 36 Months From Approved 08/31/2017
216 0 238
11,621 0 12,805
13,945,651 0 15,366,042

Form 10 is filed by issuers of securities to register a class of securities pursuant to Sections 12(b) and 12(g) of the Securities Exchange Act of 1934.

US Code: 15 USC 78m, 78n(a), 78n-1, 78w(a) Name of Law: Securities Exchange Act of 1934
   US Code: 15 USC 77c(b), 77f, 77g, 77j,77s(a) Name of Law: Securities Act of 1933
   US Code: 15 USC 78mm Name of Law: Securities Exchange Act of 1934
   PL: Pub.L. 111 - 203 951 Name of Law: Dodd-Frank Wall Street Reform and Consumer Protection Act
  
None

Not associated with rulemaking

  82 FR 14072 03/16/2017
82 FR 24411 05/26/2017
No

1
IC Title Form No. Form Name
Exchange Act Form 10 SEC 1396 Form 10

  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 216 238 0 0 -22 0
Annual Time Burden (Hours) 11,621 12,805 0 0 -1,184 0
Annual Cost Burden (Dollars) 13,945,651 15,366,042 0 0 -1,420,391 0
No
No
The decrease of 1,184 reporting burden hours and the decrease of ($1,420,391) in cost burden is due to an adjustment to reflect a decrease in the number of respondents filing Form 10 with the Commission.

$350,000
No
No
No
Yes
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.
05/30/2017


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