Information Collection

Rule 17Ac3-1(a) and Form TA-W

IC 34446 under ICR 202607-3235-007 · OMB 3235-0151.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SEC1669 Form TA-W Rule 17Ac3-1(a) and Form TA-W	Form and Instruction
SEC1669 Form TA-W formta-w[1].pdf www.sec.gov/files/formta-w.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 17Ac3-1 17 CFR 249b.101-Form TA-W (To search for a specific CFR, visit the Code of Federal Regulations.)

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	SEC1669			https://www.sec.gov/files/formta-w.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

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
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12	-38	50
Annual IC Time Burden (Hours)	6	-19	25
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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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