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 Form 700 Screenshots_Redacted 2024 v3.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 700RN Election of Retroactive Annuity Starting Date (Spousal Consent not Required) Form 700RN OMBFINAL 04052024.pdf No   Paper Only
Form and Instruction Form 700RSC Election of Retroactive Annuity Starting Date (Spousal Consent Required) Form 700RSC OMBFINAL 04052024.pdf No   Paper Only
Form and Instruction Form 703 Application for Elective Lump-Sum Payment Form 703 OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction Form 703MP Application for Elective Lump-Sum Payment Form 703MP OMBFINAL 05082024.pdf No   Paper Only
Form and Instruction Form 703RBD Application for Elective Lump-Sum Payment, post RBD Form 703RBD OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 703RBD-MP Application for Elective Lump-Sum Payment, post RBD Form 703RBD-MP OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 704 Report of Earnings and Social Security Disability Information Form 704 OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction Form 712 Uniformed Services Information Form Form 712 OMBFINAL 04082024.pdf No   Paper Only
Form and Instruction Form 713 Election to Withdraw Employee Contributions Form 713 OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 714 Withdrawal of Employee Contributions – Non-Spouse Beneficiary Form 714 OMBFINAL 04242024.pdf No   Paper Only
Form and Instruction Form 715 Power of Attorney (POA) Form 715 OMBFINAL 04082024.pdf No   Paper Only
Form and Instruction Form 720MP Application for Lump-Sum Payment Form 720MP OMBFINAL 05082024.pdf No   Paper Only
Form and Instruction Form 721 Application for Eligible Rollover Payment – Non-Spouse Beneficiary Form 721 OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 721T Tax Election for Payment Not Eligible for Rollover Form 721T OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 700 Participant Application for Pension Benefits 2025 Form 700 Participant Application for Pension Benefits.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 701 Payee Information Form Form 701 OMBFINAL 04082024.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 702 General Information Form Form 702 OMBFINAL 04052024.pdf No   Paper Only
Form and Instruction Form 705 Beneficiary Application for Pension Benefits Form 705 OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 706 Beneficiary Application for Pension Benefits - OF Form 706 OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 707 Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits) Form 707 OMBFINAL 04052024.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 708 Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits) Form 708 OMBFINAL 04052024.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 710 Application for Electronic Direct Deposit Form 710 OMBFINAL 04122024.pdf Yes Yes Fillable Fileable Signable
Form and Instruction Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only Form 711 OMBFINAL 04052024.pdf No   Paper Only
Form and Instruction Form 716 Certification of Social Security Disability Status Form 716 OMBFINAL 04082024.pdf No   Paper Only
Form and Instruction Form 716A Certification of Pension Plan Disability Status Form 716A OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction Form 717 Benefit Inquiry Questionnaire Form 717 OMBFINAL 04082024.pdf No   Paper Only
Form and Instruction Form 720 Application for Lump-Sum Payment Form 720 OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction Form 720CD Application for Lump-Sum Payment (child or dependent) Form 720CD OMBFINAL 04122024.pdf No   Paper Only
Form and Instruction Form 722 Financial Statement of Debtor Form 722 OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction 713RBD Election to Withdraw Employee Contributions, post RBD Form 713 RBD OMBFINAL 04082024.pdf No   Paper Only
Form and Instruction 714RBD Withdrawal of Employee Contributions – Non-Spouse Beneficiary Form 714 RBD OMBFINAL 04152024.pdf No   Paper Only
Form and Instruction 720MP Roth Application for Lump-Sum Payment Roth Form 720MP Roth Combo 01032023.pdf No   Paper Only
Form and Instruction 703MP Roth Application for Elective Lump-Sum Payment - Roth Account Form 703MP Roth Combo 01032023.pdf No   Paper Only

Income Security General Retirement and Disability

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

136,081 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 136,081 0 0 0 0 136,081
Annual IC Time Burden (Hours) 101,703 0 0 0 0 101,703
Annual IC Cost Burden (Dollars) 60,742 0 0 0 0 60,742

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