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

View Information Collection (IC)

Locating and Paying Participants
 
No Modified
 
Required to Obtain or Retain Benefits
 
29 CFR 4022

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction MyPBA MyPBA Screen Shots MyPBA screens related to PBGC forms_2021_v2.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 700RN Election of Retroactive Annuity Starting Date (Spousal Consent not Required) Form700RN.pdf No   Paper Only
Form and Instruction Form 700RSC Election of Retroactive Annuity Starting Date (Spousal Consent Required) Form700RSC.pdf No   Paper Only
Form and Instruction Form 703 Application for Elective Lump-Sum Payment Form703.pdf No   Paper Only
Form and Instruction Form 703MP Application for Elective Lump-Sum Payment Form703MP.pdf No   Paper Only
Form and Instruction Form 703RBD Application for Elective Lump-Sum Payment, post RBD Form703RBD.pdf No   Paper Only
Form and Instruction Form 703RBB-MP Application for Elective Lump-Sum Payment, post RBD Form703RBD-MP.pdf No   Paper Only
Form and Instruction Form 704 Report of Earnings and Social Security Disability Information Form704.pdf No   Paper Only
Form and Instruction Form 712 Uniformed Services Information Form Form712.pdf No   Paper Only
Form and Instruction Form 713 Election to Withdraw Employee Contributions Form713.pdf No   Paper Only
Form and Instruction Form 714 Withdrawal of Employee Contributions – Non-Spouse Beneficiary Form714.pdf No   Paper Only
Form and Instruction Form 715 Power of Attorney (POA) Form715.pdf No   Paper Only
Form and Instruction Form 718 Installment Payment Agreement Form718.pdf No   Paper Only
Form and Instruction Form 719 Election to Withhold Federal Income Tax from Periodic Payments Form719.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 720MP Application for Lump-Sum Payment Form720MP.pdf No   Paper Only
Form and Instruction Form 721 Application for Eligible Rollover Payment – Non-Spouse Beneficiary Form721.pdf No   Paper Only
Form and Instruction Form 721T Tax Election for Payment Not Eligible for Rollover Form721T.pdf No   Paper Only
Form and Instruction Form 700 Participant Application for Pension Benefits Form 700 NEW 020221 - WR updated 05052021 final add in annual whold 06282021 07072021.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 701 Payee Information Form Form701 exp 10312021 - draft add spouse gender 03042020 ben clar 06182020 07072021.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 702 General Information Form Form702 exp 10312021 ben clar 06172020 clean 07072021.pdf No   Paper Only
Form and Instruction Form 705 Beneficiary Application for Pension Benefits Form705 exp 10312021 2020taxinfo01272020 ben clar 06172020- remove ETA info 01082021 2021tax info 04012021 07072021.pdf No   Paper Only
Form and Instruction Form 706 Beneficiary Application for Pension Benefits - OF Form706 exp 10312021 2020taxinfo and certain period 09112019 ben clar 06182020 - remove ETA 012021 2021taxinfo 04022021 ASD 06242021 07072021.pdf No   Paper Only
Form and Instruction Form 707 Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits) Form707 exp 10312021 - ben clar 06162020 - misc edits 02022021 07072021.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 708 Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits) Form708 exp 10312021 ben clar 06172020 07072021.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 710 Application for Electronic Direct Deposit Form710 exp 10312021 - remove ETA 01112021 07072021.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only Form711 with bene clarif and spousal consent 01122021 07072021.pdf No   Paper Only
Form and Instruction Form 716 Certification of Social Security Disability Status Form716 exp 10312021 07072021.pdf No   Paper Only
Form and Instruction Form 716A Certification of Pension Plan Disability Status Form716A exp 10312021 07072021.pdf No   Paper Only
Form and Instruction Form 717 Benefit Inquiry Questionnaire Form717 exp10312021 new version 07072021.pdf No   Paper Only
Form and Instruction Form 720 Application for Lump-Sum Payment Form720 exp 10312021 07072021.pdf No   Paper Only
Form and Instruction Form 720CD Application for Lump-Sum Payment (child or dependent) Form720CD exp 10312021 - no change 07072021.pdf No   Paper Only
Form and Instruction Form 722 Financial Statement of Debtor Form722 exp 10312018 - no change 07072021.pdf No   Paper Only

Income Security General Retirement and Disability

PBGC-6: Plan Participant and Beneficiary Data  83 FR 6247

170,506 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 170,506 0 -4,891 0 0 175,397
Annual IC Time Burden (Hours) 58,376 0 -50,064 0 0 108,440
Annual IC Cost Burden (Dollars) 58,682 0 1,971 0 0 56,711

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