Information Collection

Uniform Termination Notice for Securities Principal or Represenatative

IC 230576 under ICR 202102-3064-010 · OMB 3064-0022.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0022 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FDIC 6200-55 (Revi Uniform Termination Notice for Securities Principal or Represenatative	Form
6200-55i (Ext) - MSD-5 Instructions (8-18).pdf	Instruction
6200-55i (Ext) - MSD-5 Instructions (8-18).pdf	Instruction
FDIC 6200-55 (Revi Foorm MSD-5 Uniform Termination Notice for Municipal Pri 6200-55 (8-18).pdf	Form
FDIC 6200-55 (Revi Foorm MSD-5 Uniform Termination Notice for Municipal Pri 6200-55 (8-18).pdf	Form
MSD-5 Redline.pdf Redlined Revisions to Form MSD-5 Uniform Termination Notice for Municipal Securities Principal or Municipal Securities Represent	IC Document
MSD-5 Redline.pdf Redlined Revisions to Form MSD-5 Uniform Termination Notice for Municipal Securities Principal or Municipal Securities Represent	IC Document
Justification Memo 0022 - Uniform Application - Termination Municipal Securities.docx Justification Memo -0022 Uniform Application and Termination for Municipal Securities	IC Document
Justification Memo 0022 - Uniform Application - Termination Municipal Securities.docx Justification Memo -0022 Uniform Application and Termination for Municipal Securities	IC Document

IC Title:

Uniform Termination Notice for Securities Principal or Represenatative

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Form	FDIC 6200-55 (Revised August 2018)	Foorm MSD-5 Uniform Termination Notice for Municipal Principal or Municipal Securities Representative Associated With a Bank Municipal Securities Dealer	6200-55 (8-18).pdf		Yes	Yes	Fillable Fileable
Instruction			6200-55i (Ext) - MSD-5 Instructions (8-18).pdf		Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: http://www.fdic.gov/regulations/laws/rules/2000-4050.html#200030--64--0016

FR Citation: 80 FR 66982

Number of Respondents: 2

Number of Respondents for Small Entity: 0

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	2	0	2
Annual IC Time Burden (Hours)	2	1	1
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Redlined Revisions to Form MSD-5 Uniform Termination Notice for Municipal Securities Principal or Municipal Securities Representative Associated With a Bank Municipal Securities Dealer	MSD-5 Redline.pdf	12/06/2018
Justification Memo -0022 Uniform Application and Termination for Municipal Securities	Justification Memo 0022 - Uniform Application - Termination Municipal Securities.docx	12/06/2018

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