Information Collection

Form 4 - Statement of Changes in Beneficial Ownership of Securities

IC 34761 under ICR 202602-3235-003 · OMB 3235-0287.

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IC Title:	Form 4 - Statement of Changes in Beneficial Ownership of Securities	Agency IC Tracking Number:	CF

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 249.104

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	SEC 1474			http://www.sec.gov/about/forms/form4.pdf	Yes	Yes	Fillable Fileable
Instruction				http://www.sec.gov/about/forms/form4data.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: 221,755	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	221,755	35,703	186,052
Annual IC Time Burden (Hours)	110,878	17,852	93,026
Annual IC Cost Burden (Dollars)	0	0	0

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