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IC11 - SIPC Annual Assessment Reconciliation Form or Certification of Exclusion from Membership Form
Rule 17a-5, Form X-17A-5 (FOCUS REPORT)
OMB: 3235-0123
IC ID: 226200
OMB.report
SEC
OMB 3235-0123
ICR 202304-3235-019
IC 226200
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
IC11 - SIPC Annual Assessment Reconciliation Form or Certification of Exclusion from Membership Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
17 CFR 240.17a-5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
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:
3,404
Number of Respondents for Small Entity:
895
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
3,404
0
0
-285
0
3,689
Annual IC Time Burden (Hours)
17,020
0
0
-1,425
0
18,445
Annual IC Cost Burden (Dollars)
902
0
0
-943
0
1,845
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.