Information Collection

Form 5 - Annual Statement of Beneficial Ownership

IC 34921 under ICR 202308-3235-021 · OMB 3235-0362.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0362 can be found here:

Documents and Forms

Document Name Document Type
Form SEC 2270 Form 5 - Annual Statement of Beneficial Ownership Form
form5data0.Instructions.pdf www.sec.gov/files/form5data0.pdf Instruction
form5data0.Instructions.pdf www.sec.gov/files/form5data0.pdf Instruction
SEC 2270 Form 5 Annual Statement of Beneficial Ownership form5.08-31-2026.pdf www.sec.gov/files/form5.pdf Form
SEC 2270 Form 5 Annual Statement of Beneficial Ownership form5.08-31-2026.pdf www.sec.gov/files/form5.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 5 - Annual Statement of Beneficial Ownership	Agency IC Tracking Number:	CF 270-323

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 249.105

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SEC 2270	Form 5 Annual Statement of Beneficial Ownership	form5.08-31-2026.pdf	https://www.sec.gov/files/form5.pdf	Yes	Yes	Fillable Fileable
Instruction			form5data0.Instructions.pdf	https://www.sec.gov/files/form5data0.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,533	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6,533	594	5,939
Annual IC Time Burden (Hours)	6,533	594	5,939
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.