View Information Collection Request (ICR) Package

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: 1210-0112	ICR Reference No: 202101-1210-002
Status: Historical Active	Previous ICR Reference No: 201801-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Furnishing Documents to the Secretary of Labor on Request Under Employee Retirement Income Security Act Section 104(a)(6)
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 without change	Conclusion Date: 06/15/2021
	Date Received in OIRA: 04/23/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2024	36 Months From Approved	06/30/2021
Responses	893	0	831
Time Burden (Hours)	41	0	55
Cost Burden (Dollars)	721	0	3,451

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	893	831	62
Annual Time Burden (Hours)	41	55	-14
Annual Cost Burden (Dollars)	721	3,451	-2,730

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: The estimated number of requested SPDs and SMMs has been adjusted to incorporate updated recovery data from EBSA’s Office of Outreach, Education, and Assistance. The estimates above also reflect updated postage and material costs and wage rates. Additionally, the Department assumes that 92.7 percent of respondents will provide the requested documents electronically.

Annual Cost to Federal Government: $27,556

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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? No

Agency Contact: Chris Cosby 202 693-8540

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