View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Locating and Paying Participants
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screen print MyPBA_Generate_Estimate_Screens.pdf Yes Yes Fillable Fileable Signable
Other-Screen print MyPBA_Apply_Benefits_Declare_Estimate.pdf Yes Yes Fillable Fileable Signable
Other-Screen print MyPBA_Apply_Benefits_Marriage_Info.pdf Yes Yes Fillable Fileable Signable
Form and Instruction 700 Application for Benefits 700.doc Yes Yes Fillable Fileable Signable
Form and Instruction 701 Payee Information Form 701.doc Yes Yes Fillable Fileable Signable
Form and Instruction 703 Application for Elective Lump Sum 703.doc No   Paper Only
Form and Instruction 705 Beneficiary Application for Pension Benefits 705.doc Yes Yes Fillable Fileable Signable
Form and Instruction 706 Beneficiary Application for Pension Benefits -- OF 706.doc Yes Yes Fillable Fileable Signable
Form and Instruction 707 Designation of Beneficiary 707.doc Yes Yes Fillable Fileable Signable
Form and Instruction 708 Designation of Beneficiary (Not currently receiving benefits) 708.doc Yes Yes Fillable Fileable Signable
Form and Instruction 709 Plan Participant Information 709.doc No   Paper Only
Form and Instruction 710 Application for Electronic Direct Deposit 710.doc Yes Yes Fillable Fileable Signable
Form and Instruction 713 Return of Employee Contributions, Participant 713.doc No   Paper Only
Form and Instruction 714 Surviving Spouse Election for Return of Participant Contributions 714.doc No   Paper Only
Form and Instruction 715 Power of Attorney 715.doc Yes No Printable Only
Form and Instruction 719 Election to Withhold Federal Income Tax from Periodic Payments 719.doc Yes Yes Fillable Fileable Signable
Form and Instruction 720 Application for Lump Sum Payment 720.doc No   Paper Only
Form and Instruction 721 Estate or Non-Spouse Beneficiary Application for Taxable Single Payment 721.doc No   Paper Only
Other-Screen print MyPBA 2 0 Wireframes OMB partial.pdf Yes Yes Fillable Fileable Signable
Form and Instruction 702 General Information Form 702.doc No   Paper Only
Form and Instruction 717 Monthly Payment Election Form 717.doc No   Paper Only
Form and Instruction 718 Installment Repayment Agreement 718.doc No   Paper Only
Form and Instruction 722 Financial Statement of Debtor 722.doc No   Paper Only


 

225,600 0
   
Individuals or Households
 
   5 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 225,600 0 0 0 0 225,600
Annual IC Time Burden (Hours) 118,475 0 0 0 0 118,475
Annual IC Cost Burden (Dollars) 78,000 0 0 0 0 78,000

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.