Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust

Forms and Documents

Document	Type	Status	Availability
Form SEC2125 Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust	Form	Modified	Repair queued
Form N-4 Draft Supporting Statement (3-2020).pdf	Supporting Statement A	Uploaded 2020-05-26	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
34837	Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust	Form	Modified

ICR Details

OMB Control No: 3235-0318	ICR Reference No: 202005-3235-013
Status: Active	Previous ICR Reference No: 202003-3235-002
Agency/Subagency: SEC	Agency Tracking No: IM-270-282
Title: Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/17/2020
	Date Received in OIRA: 07/17/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved	05/31/2022
Responses	1,336	0	1,361
Time Burden (Hours)	300,937	0	271,914
Cost Burden (Dollars)	30,342,168	0	32,111,916

---

Abstract: Form N-4 is the form separate accounts organized as unit investment trusts that offer variable annuities use to register under the Investment Company Act of 1940 and to offer their securities under the Securities Act of 1933.

---

Authorizing Statute(s): US Code: 15 USC 80a-8 Name of Law: Investment Company Act of 1940
   US Code: 15 USC 77e Name of Law: Securities Act of 1933
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3235-AK60	Final or interim final rulemaking	85 FR 25964	05/01/2020

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust	SEC2125	N-4

---

ICR Summary of Burden

	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	1,336	1,361	0	0	-25	0
Annual Time Burden (Hours)	300,937	271,914	0	0	29,023	0
Annual Cost Burden (Dollars)	30,342,168	32,111,916	0	0	-1,769,748	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Currently, the approved total annual hour burden for preparing and filing registration statements on Form N-4 is 271,914 internal burden hours. We estimate that the new internal burden would be approximately 300,937 hours annually, reflecting an increase of 29,023 internal burden hours associated with the amendments. The current estimate for the external annual cost burdens associated with preparing and filing initial and post-effective registration statements on Form N-4 is $32,111,916. We estimate that the new external annual cost burden would be approximately $30,342,168, reflecting a decrease of $1,769,748 associated with the amendments. These estimates reflect the increase in estimated burdens associated with the amendments, adjustments to certain per filing estimates, and current estimates for the number of filings on Form N-4.

---

Annual Cost to Federal Government: $21,200,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/17/2020

---