View Information Collection Request (ICR) Package

View ICR - Agency Submission

OMB Control No: 1212-0036	ICR Reference No: 202602-1212-001
Status: Received in OIRA	Previous ICR Reference No: 202511-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Termination of Single Employer Plans
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/27/2026

	Requested	Previously Approved
Expiration Date	09/30/2028	09/30/2028
Responses	1,870	1,870
Time Burden (Hours)	46,860	46,860
Cost Burden (Dollars)	9,558,240	9,558,240

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Termination of Single Employer Plans	Form 501, Form 500, 600, 601, and 602, Schedule MP	, , ,

Annual Cost to Federal Government: $0

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. Yes

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: Monica O'Donnell 202 229-8706 o'donnell.monica@pbgc.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.