Information Collection

Schedule I (Form 17a-5 Schedule I), under Rule 17a-10(a)(2) (17 CFR 240.17a-10(a)(2)).

IC 261066 under ICR 202307-3235-003 · OMB 3235-0122.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0122 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form sec 1696 Schedule I (Form 17a-5 Schedule I), under Rule 17a-10(a)(2) (17 CFR 240.17a-10(a)(2)).	Form
Form sec 1696 FOCUS Report Part IIA Schedule I (Form 17a-5 Schedule I), under Rule 17a-10(a)(2) (17 CFR 240.17a-10(a)(2)).	Form
Form SEC 1675 X-17a-5 Schedule I Schedule I (Form 17a-5 Schedule I), under Rule 17a-10(a)(2) (17 CFR 240.17a-10(a)(2)).	Form and Instruction
formx-17a-5_2a.pdf www.sec.gov/files/formx-17a-5_2a.pdf	Instruction
formx-17a-5_2a.pdf www.sec.gov/files/formx-17a-5_2a.pdf	Instruction
sec 1696 FOCUS Report Part IIA formx-17a-5_2f.pdf www.sec.gov/files/formx-17a-5_2f.pdf	Form
sec 1696 FOCUS Report Part IIA formx-17a-5_2f.pdf www.sec.gov/files/formx-17a-5_2f.pdf	Form
SEC 1675 X-17a-5 Schedule I formx-17a-5_schedi.pdf www.sec.gov/files/formx-17a-5_schedi.pdf	Form and Instruction
SEC 1675 X-17a-5 Schedule I formx-17a-5_schedi.pdf www.sec.gov/files/formx-17a-5_schedi.pdf	Form and Instruction

IC Title:

Schedule I (Form 17a-5 Schedule I), under Rule 17a-10(a)(2) (17 CFR 240.17a-10(a)(2)).

Agency IC Tracking Number:

240-154

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.17a-10

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	sec 1696	https://www.sec.gov/files/formx-17a-5_2f.pdf	Yes	No	Printable Only
Instruction		https://www.sec.gov/files/formx-17a-5_2a.pdf	Yes	No	Printable Only
Form and Instruction	SEC 1675	https://www.sec.gov/files/formx-17a-5_schedi.pdf	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,740

Number of Respondents for Small Entity: 895

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	3,740	3,740
Annual IC Time Burden (Hours)	44,880	44,880
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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