Information Collection

Disclosure of Material Conflicts of Interest (Small, Standalone Broker-Dealers)

IC 231763 under ICR 201804-3235-020 · OMB 3235-0762.

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Information Collection (IC) Details

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IC Title:	Disclosure of Material Conflicts of Interest (Small, Standalone Broker-Dealers)	Agency IC Tracking Number:	TM-270-808

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.15l-1(a)(2)(i)

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: 802	Number of Respondents for Small Entity: 802

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	802	802
Annual IC Time Burden (Hours)	2,139	2,139
Annual IC Cost Burden (Dollars)	630,909	630,909

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