Information Collection

Consent to Receive Employee Benefit Plan Disclosure Electronically

IC 13498 under ICR 200204-1210-001 · OMB 1210-0121.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0121 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Consent to Receive Employee Benefit Plan Disclosure Electronically	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

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: 50,000	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
Annual Number of Responses for this IC	50,000	50,000
Annual IC Time Burden (Hours)	5,042	5,042
Annual IC Cost Burden (Dollars)	2,447,000	2,447,000

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.