Exchange Act Form 10

Forms and Documents

Document Name	Status
Form SEC 1396 Exchange Act Form 10 Form and Instruction	Modified
SOP Adopting PRA Supporting Statement 3 1 11.docx Supporting Statement A	2011-03-01

IC Document Collections

IC ID	Document Title	Status
34221	Exchange Act Form 10 Form and Instruction	Modified

ICR Details

OMB Control No: 3235-0064	ICR Reference No: 201102-3235-030
Status: Historical Active	Previous ICR Reference No: 201002-3235-005
Agency/Subagency: SEC	Agency Tracking No: CF270-51
Title: Exchange Act Form 10
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/24/2011
	Date Received in OIRA: 03/03/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	04/30/2013
Responses	238	0	238
Time Burden (Hours)	12,805	0	12,801
Cost Burden (Dollars)	15,368,000	0	15,362,400

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Abstract: Form 10 is filed by issuers of securities to register a class of securities pursuant to Sections 12(b) and 12(g) of the Securities Exchange Act of 1934.

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Authorizing Statute(s): US Code: 15 USC 77c(b), 77f, 77g, 77j,77s(a) Name of Law: Securities Act of 1933
   US Code: 15 USC 78m, 78n(a), 78n-1, 78w(a) Name of Law: Securities Exchange Act of 1934
   US Code: 15 USC 78mm Name of Law: Securities Exchange Act of 1934
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 203 951 Name of Law: Dodd-Frank Wall Street Reform and Consumer Protection Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3235-AK68	Final or interim final rulemaking	76 FR 6010	02/02/2011

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Exchange Act Form 10	SEC 1396	Form 10

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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	238	238	0	0	0	0
Annual Time Burden (Hours)	12,805	12,801	4	0	0	0
Annual Cost Burden (Dollars)	15,368,000	15,362,400	5,600	0	0	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: We anticipate that the amendments will increase the burdens and costs for U.S. companies. The amendments will increase existing burdens by requiring companies to make additional disclosures of the following: • the shareholder say-on-pay votes and frequency and the general effect of such votes, such as whether the vote is non-binding; • whether and, if so, how companies have taken into account the results of shareholder advisory votes on executive compensation; • decision regarding how frequently it will conduct say-on-pay votes in light of the results of the shareholder vote on frequency; and • disclosure of golden parachute compensation arrangements in connection with mergers, acquisitions, tender offers and going-private transactions. With respect to reporting companies, portions of the new disclosure will be required in Schedules 14A, 14C, 14D-9, and 13E-3. Additional disclosure will also be required in Forms 10, 8-K, S-1, S-4, F-4, S-11 and N-2. With respect to Form 10 we estimate an annual increase of 4 burden hours and an increase of $5,600 in costs.

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Annual Cost to Federal Government: $100,000

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]? Yes

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 03/03/2011

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