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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:
1212-0055
ICR Reference No:
201008-1212-001
Status:
Historical Active
Previous ICR Reference No:
200807-1212-006
Agency/Subagency:
PBGC
Agency Tracking No:
Title:
Locating and Paying Participants
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/05/2010
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/09/2010
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2013
09/30/2011
09/30/2011
Responses
84,800
0
89,100
Time Burden (Hours)
67,050
0
73,300
Cost Burden (Dollars)
3,730
0
3,100
Abstract:
This collection consists of information participants and beneficiaries are asked to provide in connection with an application for benefits or request for a benefit estimate. In addition, in some instances, as part of a search for participants and beneficiaries who may be entitled to benefits, the PBGC requests individuals to provide identifying information that the individual would provide as part of an initial contact with the PBGC.
Authorizing Statute(s):
PL:
Pub.L. 109 - 280 410
Name of Law: Pension Protection Act of 2006
US Code:
29 USC 1322, 1350
Name of Law: Employee Retirement Security Act (ERISA)
Citations for New Statutory Requirements:
PL: Pub.L. 109 - 280 410 Name of Law: Pension Protection Act of 2006
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 30865
06/02/2010
30-day Notice:
Federal Register Citation:
Citation Date:
75 FR 47857
08/09/2010
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
Locating and Paying Participants
714, 703MP, 719, 710, 711, 706, 721, 700, 701, 708, 717, 705, 702, 718, 722, 703, 715, 713, 720MP, 720, 709, 707, 720CD, Form 716A, Form 712, Form 716, Form 704
Participant Application for Pension Benefits
,
Payee Information Form
,
General Information Form
,
Application for Elective Lump-Sum Payment
,
Application for Elective Lump-Sum Payment
,
Beneficiary Application for Pension Benefits
,
Beneficiary Application for Pension Benefits -- OF
,
Designation of Beneficiary for Benefits Owed at Death
,
Designation of Beneficiary
,
Plan Participation Information
,
Application for Electronic Direct Deposit
,
Change of Beneficiary for Certain & Continuous (C&C) Benefits Only
,
Application for Payment of Employee Contributions
,
Application for Payment of Employee Contributions -- Non-Spouse Beneficiary
,
Power of Attorney (POA)
,
Monthly Payment Election Form
,
Installment Payment Agreement
,
Election to Withhold Federal Income Tax from Periodic Payments
,
Application for Lump-Sum Payment
,
Application for Lump-Sum Payment
,
Application for Lum-Sum Payment
,
Application for Lump-Sum Payment -- Non-spouse Beneficiary or Estate
,
Financial Statement of Debtor
,
Request for Earnings Information
,
Certification of Social Security Disability Status
,
Uniformed Services Information Form
,
Certification of Pension Plan Disability Status
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
84,800
89,100
0
0
-4,300
0
Annual Time Burden (Hours)
67,050
73,300
0
0
-6,250
0
Annual Cost Burden (Dollars)
3,730
3,100
0
0
630
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:
$6,863,600
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:
Josephine Burns 2023264223 ext. 3072 burns.jo.amato@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:
08/09/2010
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