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Form 1-SA
Form 1-SA
OMB: 3235-0721
IC ID: 212628
OMB.report
SEC
OMB 3235-0721
ICR 201806-3235-020
IC 212628
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0721 can be found here:
2022-07-27 - Extension without change of a currently approved collection
2019-06-03 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form SEC 2914
Form 1-SA
Form and Instruction
SEC 2914 Form 1-SA
form1-sa.07-31-2018.pdf
www.sec.gov/files/form1-sa.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Form 1-SA
Agency IC Tracking Number:
CF 270-661
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
17 CFR 239.92
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SEC 2914
Form 1-SA
form1-sa.07-31-2018.pdf
https://www.sec.gov/files/form1-sa.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Economic Development
Subfunction:
Financial Sector Oversight
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
55
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
55
0
0
-133
0
188
Annual IC Time Burden (Hours)
8,763
0
0
-21,189
0
29,952
Annual IC Cost Burden (Dollars)
618,420
0
0
-1,495,452
0
2,113,872
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.