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OMB Control No: 1212-0017	ICR Reference No: 202606-1212-001
Status: Received in OIRA	Previous ICR Reference No: 202307-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Liability for Termination of Single-Employer Plans
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: 06/04/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	19	21
Time Burden (Hours)	228	252
Cost Burden (Dollars)	102,600	113,400

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	19	21	-2
Annual Time Burden (Hours)	228	252	-24
Annual Cost Burden (Dollars)	102,600	113,400	-10,800

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The changes in the estimates of the annual time and dollar burden are due to the change, based on PBGC’s experience, in the estimated number of employers, from 21 to 19, that will respond to this information collection annually.

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: Abigail Davidow 202 702-5030 davidow.abigail1@pbgc.gov

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