Uniform Application/Uniform Termination for Municipal Securities Principal or Representative

Forms and Documents

Document Name	Status
Form MSD-4 Uniform Application/Uniform Termination for Municipal Securities Principal or Representative Form	Modified
Justification Memo 0022 - Nonsubstantive Revisions to MSD-4 and MSD-5 forms and instructions.docx Justification for No Material/Nonsubstantive Change	2017-02-08
SPST-0022 2014 Renewal Uniform App-Term.doc Supporting Statement A	2017-02-08
Insts_MSD-5_PII_removal_mockup.pdf Supplementary Document	2017-02-07
Form MSD-5_PII_removal_mockup.pdf Supplementary Document	2017-02-07
Insts_MSD-4_PII_removal_mockup.pdf Supplementary Document	2017-02-07
Form MSD-4_PII_removal_mockup.pdf Supplementary Document	2017-02-07

IC Document Collections

IC ID	Document Title	Status
31758	Uniform Application/Uniform Termination for Municipal Securities Principal or Representative Form	Modified

ICR Details

OMB Control No: 3064-0022	ICR Reference No: 201702-3064-003
Status: Historical Active	Previous ICR Reference No: 201408-3064-002
Agency/Subagency: FDIC	Agency Tracking No:
Title: Uniform Application/Uniform Termination for Municipal Securities Principal or Representative
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/10/2017
	Date Received in OIRA: 02/08/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2018	03/31/2018	03/31/2018
Responses	75	0	75
Time Burden (Hours)	75	0	75
Cost Burden (Dollars)	0	0	0

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Abstract: An insured state nonmember bank that serves as a municipal securities dealer must file Form MSD-4 or MSD-5, as applicable, to permit an employee to become associated, or to terminate the association, with the municipal securities dealer. FEB 2017 - The agencies are making nonsubstantive revisions to the forms and instructions associated with this information collection to remove a requirement to provide Social Security Number information and to permit alternative means of filing.

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Authorizing Statute(s): US Code: 15 USC 78o-4 Name of Law: Securities Exchange Act of 1934
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 62616	10/20/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 78090	12/29/2014
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
Uniform Application/Uniform Termination for Municipal Securities Principal or Representative	MSD-4, MSD-5	Uniform Application for Muncipal Securities Principal or Rep ,   Uniform Termination Notice for Municipal Securities Principal

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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	75	75	0	0	0	0
Annual Time Burden (Hours)	75	75	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	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:

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Annual Cost to Federal Government: $0

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]? 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: 02/08/2017

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