Information Collection

Rule 17a-5(c): Exempt firms sending financial disclosure statements to customers

IC 34552 under ICR 201804-3235-017 · OMB 3235-0199.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0199 can be found here:

Documents and Forms

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Document Name	Document Type

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IC Title:

Rule 17a-5(c): Exempt firms sending financial disclosure statements to customers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.17a-5(c)

Information Collection Instruments:

table that charts list of 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: 129

Number of Respondents for Small Entity: 2

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	258	-82	340
Annual IC Time Burden (Hours)	10,320	-3,280	13,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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