Information Collection

Rule 3a68-4(c) - no Rule 3a68-2 request made

IC 217880 under ICR 202408-3235-027 · OMB 3235-0685.

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IC Title:

Rule 3a68-4(c) - no Rule 3a68-2 request made

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 17 CFR 240.3a68-4(c)

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

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	30	0	30
Annual IC Cost Burden (Dollars)	29,200	9,200	20,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.