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OMB Control No: 1210-0053	ICR Reference No: 202603-1210-004
Status: Received in OIRA	Previous ICR Reference No: 202301-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Employee Benefit Plan Claims Procedure Under the Employee Retirement Income Security Act
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 04/03/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2026
Responses	1,910,577,375	1,436,422,678
Time Burden (Hours)	38,050,660	28,981,362
Cost Burden (Dollars)	501,736,152	262,290,654

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,910,577,375	1,436,422,678	474,154,697
Annual Time Burden (Hours)	38,050,660	28,981,362	9,069,298
Annual Cost Burden (Dollars)	501,736,152	262,290,654	239,445,498

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: No program changes have been made since the previous submission. This information collection uses updated wages, mailing costs, and updated data inputs. The number of responses has increased by 27,007,330. The number of respondents has increased by 448,383. These changes have increased the hour burden and cost burden. The hour burden has increased by 560,455 hours and the cost burden has increased by $122,069,314.

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. 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: James Butikofer 202 693-8434 Butikofer.James@dol.gov

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