Information Collection

Report on Income and Expense, Rule 17a-10 (17 CFR 240.17a-10).

IC 34396 under ICR 201705-3235-015 · OMB 3235-0122.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0122 can be found here:

Documents and Forms

Document Name Document Type
Form X-17A-5 Report on Income and Expense, Rule 17a-10 (17 CFR 240.17a-10). Form
X-17A-5 FOCUS Report 17a-10 Forms.PDF www.sec.gov/about/forms Form
X-17A-5 Focus Report formx-17a-5_2a.pdf Form
X-17A-5 FOCUS REPORT formx-17a-5_2.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Report on Income and Expense, Rule 17a-10 (17 CFR 240.17a-10).	Agency IC Tracking Number:	240-154

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.17a-10

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	X-17A-5	FOCUS Report	17a-10 Forms.PDF	www.sec.gov/about/forms	Yes	No	Printable Only
Form	X-17A-5	Focus Report	formx-17a-5_2a.pdf		Yes	No	Printable Only
Form	X-17A-5	FOCUS REPORT	formx-17a-5_2.pdf		Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 38	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	Previously Approved
Annual Number of Responses for this IC	38	38
Annual IC Time Burden (Hours)	456	456
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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