Form 1-K

ICR 202110-3235-014

OMB: 3235-0720

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2021-10-25
Supplementary Document
2021-10-25
Supporting Statement A
2021-10-25
Supplementary Document
2021-10-25
IC Document Collections
IC ID
Document
Title
Status
212626 Modified
ICR Details
3235-0720 202110-3235-014
Received in OIRA 201806-3235-019
SEC CF 270-662
Form 1-K
Extension without change of a currently approved collection   No
Regular 10/27/2021
  Requested Previously Approved
36 Months From Approved 10/31/2021
36 36
16,200 16,200
2,160,000 2,160,000

Form 1-K is used to file annual reports by Tier 2 issuers under Regulation A, an exemption from registration under the Securities Act of 1933.

US Code: 15 USC 78l, 78o, 78w(a), 78mm Name of Law: Securities Exchange Act of 1934
   US Code: 15 USC 77c(b), 77s, 77z-3 Name of Law: Securities Act of 1933
   PL: Pub.L. 112 - 106 401 Name of Law: Jumpstart Our Business Startups Act
  
None

Not associated with rulemaking

  86 FR 44460 08/12/2021
86 FR 58969 10/25/2021
No

1
IC Title Form No. Form Name
Form 1-K SEC 2913 Form 1-K

  Total Request 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 36 36 0 0 0 0
Annual Time Burden (Hours) 16,200 16,200 0 0 0 0
Annual Cost Burden (Dollars) 2,160,000 2,160,000 0 0 0 0
No
No

$103,479,690
No
    Yes
    No
No
No
No
No
Sean Harrison 202 942-2910

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/27/2021


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