Information Collection

Form N-5 (17 CFR 239.24) under the Securities Act of 1933 (17 CFR 239.24) and the Investment Company Act of 1940 (17 CFR 274.5). Registration Statement of Small Business Investment Company

IC 34489 under ICR 201712-3235-012 · OMB 3235-0169.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0169 can be found here:

Documents and Forms

Document Name Document Type
Form SEC-993 Form N-5 (17 CFR 239.24) under the Securities Act of 1933 (17 CFR 239.24) and the Investment Company Act of 1940 (17 CFR 274.5). Registration Statement of Small Business Investment Company Form and Instruction
SEC-993 Form N-5 formn-5.pdf www.sec.gov/about/forms/formn-5.pdf Form and Instruction
EDGAR PIA_Redacted.pdf EDGAR PIA REDACTED IC Document
secsorn1.pdf SEC SORN 1 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form N-5 (17 CFR 239.24) under the Securities Act of 1933 (17 CFR 239.24) and the Investment Company Act of 1940 (17 CFR 274.5). Registration Statement of Small Business Investment Company	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 239.24 17 CFR 274.5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SEC-993	Form N-5	formn-5.pdf	http://www.sec.gov/about/forms/formn-5.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title: SEC SORN 1Registration Statements Filed Pursuant to Provisions of the Securities Act of 1933, Securities Exchange Act of 1934, Public Utility Holding Company Act of 1935, and Investment Company Act of	FR Citation: 41 FR 41550

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	118	1	117
Annual IC Cost Burden (Dollars)	10,400	400	10,000

Documents for IC

Title	Document	Date Uploaded
EDGAR PIA REDACTED	EDGAR PIA_Redacted.pdf	11/10/2015
SEC SORN 1	secsorn1.pdf	11/18/2015

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