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View Information Collection (IC) List
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1212-0057
ICR Reference No:
201006-1212-005
Status:
Historical Active
Previous ICR Reference No:
201005-1212-001
Agency/Subagency:
PBGC
Agency Tracking No:
Title:
Annual Information Return/Report
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
04/25/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/17/2010
Terms of Clearance:
Approved consistent with PBGC revisions.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2014
36 Months From Approved
04/30/2011
Responses
30,300
0
30,300
Time Burden (Hours)
1,200
0
1,200
Cost Burden (Dollars)
1,250,000
0
1,250,000
Abstract:
Sections 104 and 4065 of ERISA require plan administrators to file an annual report. The report must contain the information described in section 103 of ERISA. The Form 5500 Series provides a standard format for fulfilling that requirement.
Authorizing Statute(s):
US Code:
29 USC 1302(b)(3), 1365
Name of Law: ERISA
Citations for New Statutory Requirements:
Statute at Large: 120 Stat. 780 Name of Statute: Pension Protection Act of 2006
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
1210-AB06
Final or interim final rulemaking
71 FR 41392
07/21/2006
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 36127
06/24/2010
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Annual Information Return/Report
2010 5500 and 2010 5500-SF, 2009 5500 and 2010 5500-SF, 2009 Form 5500 , 2009 Schedule I, 2009 Schedule R, 2010 Schedule C, 2010 Schedule G, 2010 Schedule I, 2010 Schedule R, 2010 Schedule H, 2010 Schedule D, 2010 Schedule MB, 2009 Schedule C , 2009 Schedule H, 2009 Schedule G, 2009 Schedule MB, 2010 Schedule A, 2010 Form 5500-SF, 2009 Schedule SB, 2010 Form 5500, 2010 Schedule SB, 2009 Schedule D, 2009 Schedule A, 2009 Form 5500-SF
2010 Annual Return/Report of Employee Benefit Plan and 2010 Short Form Annual Return/Report of Small Employee Benefit Plan
,
2009 Annual Return/Report of Employee Benefit Plan and 2009 Short Form Annual Return/Report of Small Employee Benefit Plan
,
2009 Form 5500 Screen Shot
,
2009 Form 5500-SF Screen Shot
,
2009 Schedule A Screen Shot
,
2009 Schedule C Screen Shot
,
2009 Schedule D Screen Shot
,
2009 Schedule G Screen Shot
,
2009 Schedule H Screen Shot
,
2009 Schedule I Screen Shot
,
2009 Schedule MB Screen Shot
,
2009 Schedule R Screen Shot
,
2009 Schedule SB Screen Shot
,
2010 Form 5500 Screen Shot
,
2010 Form 5500-SF Screen Shot
,
2010 Schedule A Screen Shot
,
2010 Schedule C Screen Shot
,
2010 Schedule D Screen Shot
,
2010 Schedule G Screen Shot
,
2010 Schedule H Screen Shot
,
2010 Schedule I Screen Shot
,
2010 Schedule MB Screen Shot
,
2010 Schedule R Screen Shot
,
2010 Schedule SB Screen Shot
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
30,300
30,300
0
0
0
0
Annual Time Burden (Hours)
1,200
1,200
0
0
0
0
Annual Cost Burden (Dollars)
1,250,000
1,250,000
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:
Annual Cost to Federal Government:
$671,000
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]?
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
Agency Contact:
Grace Kraemer 2023264223 ext. 3865 kraemer.grace@pbgc.gov
Common Form ICR:
No
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:
09/17/2010
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