Information Collection

Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)

IC 13351 under ICR 200011-1210-001 · OMB 1210-0053.

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Information Collection (IC) Details

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IC Title:	Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)	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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,700,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

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	118,000,000	-47,120,457	101,803,457	63,317,000
Annual IC Time Burden (Hours)	316,000	162,000	-350,000	504,000
Annual IC Cost Burden (Dollars)	95,637,000	55,387,000	-14,270,000	54,520,000

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.