Information Collection

Stand-alone SBSDs: Paragraphs (a)(13), (a)(14), and (a)(16)

IC 222093 under ICR 202311-3235-004 · OMB 3235-0745.

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Information Collection (IC) Details

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IC Title:	Stand-alone SBSDs: Paragraphs (a)(13), (a)(14), and (a)(16)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.18a-5

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	11	5	6
Annual IC Time Burden (Hours)	1,045	475	570
Annual IC Cost Burden (Dollars)	0	0	0

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