Form 5500 Annual Return/Report of Employee Benefit Plan

ICR 200108-1210-002

OMB: 1210-0110

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
13466 Migrated
ICR Details
1210-0110 200108-1210-002
Historical Active 200009-1210-007
DOL/EBSA
Form 5500 Annual Return/Report of Employee Benefit Plan
Extension without change of a currently approved collection   No
Regular
Approved without change 10/31/2001
Retrieve Notice of Action (NOA) 08/31/2001
  Inventory as of this Action Requested Previously Approved
12/31/2004 12/31/2004 09/30/2001
863,682 0 801,934
1,847,163 0 1,817,412
546,789,000 0 517,367,000

Section 104 and 4065 of ERISA require plan administrators to file an annual report containing the information described in section 103 of ERISA. The Form 5500 provides a standard format for fulfilling that requiement.

None
None


No

1
IC Title Form No. Form Name
Form 5500 Annual Return/Report of Employee Benefit Plan FORM-5500

  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 863,682 801,934 0 0 61,748 0
Annual Time Burden (Hours) 1,847,163 1,817,412 0 0 29,751 0
Annual Cost Burden (Dollars) 546,789,000 517,367,000 0 0 29,422,000 0
No
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.
08/31/2001


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