Information Collection

Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust

IC 34837 under ICR 202407-3235-020 · OMB 3235-0318.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC2125 Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust	Form
Form SEC2125 N-4 Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust	Form
SEC2125 N-4 formn-4.pdf www.sec.gov/about/forms/formn-4.pdf	Form
SEC2125 N-4 formn-4.pdf www.sec.gov/about/forms/formn-4.pdf	Form
EDGAR PIA 2016.pdf Edgar PIA	IC Document
EDGAR PIA 2016.pdf Edgar PIA	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Form N-4 (17 CFR 239.17b) under the Securities Act of 1933 and (17 CFR 274.11c) under the Investment Company Act of 1940, registration statement of separate accounts organized as unit investment trust

Agency IC Tracking Number:

270-282

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 239.17b 17 CFR 274.11c

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	SEC2125			http://www.sec.gov/about/forms/formn-4.pdf	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,235

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,235	-131	1,366
Annual IC Time Burden (Hours)	364,300	71,813	292,487
Annual IC Cost Burden (Dollars)	31,975,980	-1,372,886	33,348,866

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Edgar PIA		02/08/2019

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

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