Information Collection

Rule 6a-4 and Form 1-N

IC 35382 under ICR 202512-3235-021 · OMB 3235-0554.

Documents and Forms

Document Name Document Type
Form SEC 2568 (11-02) Form 1-N Rule 6a-4 and Form 1-N Form and Instruction
SEC 2568 (11-02) Form 1-N form1-n.pdf www.sec.gov/files/form1-n.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rule 6a-4 and Form 1-N	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.6a-4

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SEC 2568 (11-02)	Form 1-N	form1-n.pdf	https://www.sec.gov/files/form1-n.pdf	Yes	No	Printable Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3	1	2
Annual IC Time Burden (Hours)	45	15	30
Annual IC Cost Burden (Dollars)	327	127	200

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.

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