ANNUAL REPORT OF EMPLOYEE BENEFIT PLANS

ICR 199512-1212-003

OMB: 1212-0026

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
38431 Migrated
ICR Details
1212-0026 199512-1212-003
Historical Active 199408-1212-002
PBGC
ANNUAL REPORT OF EMPLOYEE BENEFIT PLANS
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/05/1995
Retrieve Notice of Action (NOA) 12/05/1995
  Inventory as of this Action Requested Previously Approved
10/31/1997 10/31/1997 10/31/1997
106,407 0 106,407
24,831 0 25,379
0 0 0

SECTION 4065 OF ERISA REQUIRES COVERED DEFINED BENEFIT PLANS TO FILE A ANNUAL REPORT CONTAINING CERTAIN INFORMATION. THE FORM 5500 SERIES PROVIDES A STANDARD FORMAT FOR FULFILLING THIS REQUIREMENT.

None
None


No

1
IC Title Form No. Form Name
ANNUAL REPORT OF EMPLOYEE BENEFIT PLANS 5500, 5500-C, 5500-R

  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 106,407 106,407 0 0 0 0
Annual Time Burden (Hours) 24,831 25,379 0 -548 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/05/1995


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