Information Collection

IC12 - SCI event notice required by Rule 1002(b)(3)

IC 232074 under ICR 202410-3235-003 · OMB 3235-0703.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form SCI IC12 - SCI event notice required by Rule 1002(b)(3)	Form and Instruction
Form Form SCI Form SCI IC12 - SCI event notice required by Rule 1002(b)(3)	Form and Instruction
Form SCI Form SCI Form SCI.pdf www.sec.gov/files/form-sci.pdf	Form and Instruction
Form SCI Form SCI Form SCI.pdf www.sec.gov/files/form-sci.pdf	Form and Instruction
SRTS EFFS PIA (FINAL)_Redacted.pdf EFFS Privacy Impact Assessment (PIA)	IC Document
SRTS EFFS PIA (FINAL)_Redacted.pdf EFFS Privacy Impact Assessment (PIA)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 242.1002(b)

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 and Instruction	Form SCI			https://www.sec.gov/files/form-sci.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title: (SEC 49) Broker-Dealer Records

FR Citation: 64 FR 69051

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	110	2	108
Annual IC Time Burden (Hours)	578	11	567
Annual IC Cost Burden (Dollars)	30,381	552	29,829

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
EFFS Privacy Impact Assessment (PIA)		05/21/2015

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

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