Information Collection

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

IC 43001 under ICR 202003-3235-001 · OMB 3235-0316.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0316 can be found here:

Documents and Forms

Document Name Document Type
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
Form 2124 Form N-3 formn-3.pdf www.sec.gov/about/forms/formn-3.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	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	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 274.11b 17 CFR 239.17a

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 2124	Form N-3	formn-3.pdf	https://www.sec.gov/about/forms/formn-3.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8	-6	14
Annual IC Time Burden (Hours)	1,491	-1,027	2,518
Annual IC Cost Burden (Dollars)	164,152	8	164,144

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.