Payment of Premiums -- 29 CFR part 4007, Disclosure to Participants -- 29 CFR part 4011

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0009 can be found here:

Documents and Forms

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no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

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IC Title:	Payment of Premiums -- 29 CFR part 4007, Disclosure to Participants -- 29 CFR part 4011	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FORM-1				No	No
Form	FORM-1-ES				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	60,900	-6,000	0	66,900
Annual IC Time Burden (Hours)	3,804	-77,016	0	80,820
Annual IC Cost Burden (Dollars)	10,553,000	0	10,553,000	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.