Rule 147(f)(1)(iii) Written Representation as to Purchaser Residency

ICR 202003-3235-009

OMB: 3235-0756

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2020-03-26
Supplementary Document
2020-03-26
Supporting Statement A
2020-03-24
Supplementary Document
2020-03-11
Supplementary Document
2020-03-11
IC Document Collections
ICR Details
3235-0756 202003-3235-009
Active 201701-3235-005
SEC CF-270-805
Rule 147(f)(1)(iii) Written Representation as to Purchaser Residency
Extension without change of a currently approved collection   No
Regular
Approved without change 06/16/2020
Retrieve Notice of Action (NOA) 03/26/2020
  Inventory as of this Action Requested Previously Approved
06/30/2023 36 Months From Approved 06/30/2020
700 0 700
1,925 0 1,925
70,000 0 70,000

Rule 147 is a safe harbor under the Securities Act Section 3(a)(11) exemption from registration. To qualify for the safe harbor, Rule 147(f)(1)(iii) (17 CFR 230.147) will require the issuer to obtain from the purchaser a written representation as to the purchaser's residency.

US Code: 15 USC 77c(b)(1), 77s, 77z-3 Name of Law: Securities Act of 1933
   US Code: 15 USC 78l, 78m, 78o,78w(a), 78mm Name of Law: Securities Exchange Act of 1934
  
None

Not associated with rulemaking

  84 FR 67763 12/11/2019
85 FR 14257 03/11/2020
No

1
IC Title Form No. Form Name
Rule 147(f)(1)(iii) Written Representation as to Purchaser Residency

  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 700 700 0 0 0 0
Annual Time Burden (Hours) 1,925 1,925 0 0 0 0
Annual Cost Burden (Dollars) 70,000 70,000 0 0 0 0
No
No

$102,000,000
No
    No
    No
No
No
No
No
Sean Harrison 202 942-2910

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/26/2020


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