Form N-6 (17 CFR 239.17c) under the Securities Act of 1933 and (17 CFR 274.11d) under the Investment Company Act of 1940, Registration Statement of Separate Accounts Organized as Unit Investment Trust

Forms and Documents

Document Name	Status
Form SEC 2567 Form N-6 (17 CFR 239.17c) under the Securities Act of 1933 and (17 CFR 274.11d) under the Investment Company Act of 1940, Registration Statement of Separate Accounts Organized as Unit Investment Trust Form and Instruction	Modified
Form N-6 Supporting Statement 2-19-15 (2).pdf Supporting Statement A	2015-09-17

IC Document Collections

IC ID	Document Title	Status
35269	Form N-6 (17 CFR 239.17c) under the Securities Act of 1933 and (17 CFR 274.11d) under the Investment Company Act of 1940, Registration Statement of Separate Accounts Organized as Unit Investment Trust Form and Instruction	Modified

ICR Details

OMB Control No: 3235-0503	ICR Reference No: 201502-3235-006
Status: Historical Active	Previous ICR Reference No: 201207-3235-010
Agency/Subagency: SEC	Agency Tracking No: IM-270-466
Title: Form N-6 (17 CFR 239.17c) under the Securities Act of 1933 and (17 CFR 274.11d) under the Investment Company Act of 1940, Registration Statement of Separate Accounts Organized as Unit Investment Trust
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/22/2015
	Date Received in OIRA: 09/17/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2018	36 Months From Approved	10/31/2015
Responses	472	0	436
Time Burden (Hours)	85,269	0	34,349
Cost Burden (Dollars)	5,316,892	0	3,820,447

---

Abstract: Form N-6 is the form used by insurance company separate accounts organized as unit investment trusts that offer variable life insurance contracts to register as investment companies under the Investment Company Act of 1940 [15 U.S.C. 80a-1 et seq.] ("Investment Company Act") and/or to register their securities under the Securities Act of 1933 [15 U.S.C. 77a et seq.].

---

Authorizing Statute(s): US Code: 15 USC 77e Name of Law: Securities Act of 1933
   US Code: 15 USC 80a-8 Name of Law: Investment Company Act of 1940
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 13053	03/12/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 28037	05/15/2015
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Form N-6 (17 CFR 239.17c) under the Securities Act of 1933 and (17 CFR 274.11d) under the Investment Company Act of 1940, Registration Statement of Separate Accounts Organized as Unit Investment Trust	SEC 2567	Form N-6

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	472	436	0	0	36	0
Annual Time Burden (Hours)	85,269	34,349	0	0	50,920	0
Annual Cost Burden (Dollars)	5,316,892	3,820,447	0	0	1,496,445	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Currently, the approved annual hour burden for preparing and filing registration statements on Form N-6 is 4,349 hours based on the previous estimate of 439 responses. The new estimate of the total annual hour burden is85,269 hours based on the new estimated total number of responses of 472. The increase to the total annual hour burden is 50,920 hours. Currently, the approved annual cost burden for Form N-6 is $3,820,447. The new estimate of the annual cost burden for the form is $5,316,892, reflecting an increase in annual cost burden of $1,496,445. The increases in requested total annual hour and total annual cost burdens reflect the increase in the estimated number of responses.

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/17/2015

---