Form N-3 under the Securities Act of 1933 and under the Investment Company Act of 1940, registration of separate accounts organized as management investment companies.

Forms and Documents

Document Name	Status
Form Form 2124 Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 and (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Management Investment Form and Instruction	Modified
161121_Form N-3_Supporting Statement (2017).pdf Supporting Statement A	2017-09-15
EDGAR PIA 2016.pdf Supplementary Document	2017-05-30

IC Document Collections

IC ID	Document Title	Status
43001	Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 and (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Management Investment Form and Instruction	Modified

ICR Details

OMB Control No: 3235-0316	ICR Reference No: 201709-3235-012
Status: Historical Active	Previous ICR Reference No: 201612-3235-025
Agency/Subagency: SEC	Agency Tracking No: IM 270-281
Title: Form N-3 under the Securities Act of 1933 and under the Investment Company Act of 1940, registration of separate accounts organized as management investment companies.
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: 10/30/2017
	Date Received in OIRA: 09/15/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved	12/31/2018
Responses	16	0	20
Time Burden (Hours)	2,500	0	3,104
Cost Burden (Dollars)	164,144	0	205,180

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Abstract: Form N-3 is the form separate accounts organized as management investment companies use to register under the Investment Company Act of 1940 [15 U.S.C. 80a-1 et seq.] and to offer their securities under the Securities Act of 1933 [15 U.S.C. 77a et seq.]. The SEC uses the information filed in registration statements to verify compliance with the federal securities laws.

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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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3235-AL42	Final or interim final rulemaking	81 FR 81870	11/18/2016

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Form N-3 (17 CFR 239.17a) under the Securities Act of 1933 and (17 CFR 274.11b) under the Investment Company Act of 1940. Registration Statement of Separate Accounts Organized as Management Investment	Form 2124	Form N-3

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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	16	20	0	0	-4	0
Annual Time Burden (Hours)	2,500	3,104	0	0	-604	0
Annual Cost Burden (Dollars)	164,144	205,180	0	0	-41,036	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: Annual Hour Burden. Currently, the approved annual hour burden for preparing and filing registration statements on Form N-3 is 3,104 hours based on the previous estimate of 20 responses per year. The new estimate of the total annual hour burden is 2,499.2 hours based on the new estimate of 16 responses per year and takes into account the average additional annual hour burden of one hour in connection with amendments to Form N-3 concerning securities lending activities. The decrease in the total annual hour burden is 604.8 hours. This decrease is due to the decrease in our estimates of the annual number of responses for post-effective amendments. Total Cost Burden. The current approved total cost burden for preparing and filing registration statements on Form N-3 is $205,180, based on the previous estimate of 20 responses per year. Based on the new estimate of 16 responses per year, the new estimate of the total cost burden is $164,144 in external costs per year, resulting in a decrease of $41,036 per year. This decrease is due to the decrease in our estimates of the annual number of responses for post-effective amendments.

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Annual Cost to Federal Government:

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

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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: 09/15/2017

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