Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)

ICR 200002-1210-001

OMB: 1210-0116

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1210-0116 200002-1210-001
Historical Active
DOL/EBSA
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
New collection (Request for a new OMB Control Number)   No
Emergency 03/06/2000
Approved without change 03/02/2000
Retrieve Notice of Action (NOA) 02/10/2000
  Inventory as of this Action Requested Previously Approved
11/30/2000 11/30/2000
2,678 0 0
874 0 0
394,000 0 0

ERISA 101(g)(h) authorizes the Secretary of Labor to require annual reporting by certain multiple employer welfare arrangements for the purpose of determining the extent of their compliance with Part 7 of ERISA.

None
None


No

1
IC Title Form No. Form Name
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) M-1

  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 2,678 0 0 2,678 0 0
Annual Time Burden (Hours) 874 0 0 874 0 0
Annual Cost Burden (Dollars) 394,000 0 0 394,000 0 0
Yes
No

$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.
02/10/2000


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