Payment of Premiums (29 CFR Part 4007), Disclosure to Participants (29 CFR Part 4011)

ICR 200310-1212-002

OMB: 1212-0009

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1212-0009 200310-1212-002
Historical Active 200112-1212-002
PBGC
Payment of Premiums (29 CFR Part 4007), Disclosure to Participants (29 CFR Part 4011)
Extension without change of a currently approved collection   No
Regular
Approved with change 11/25/2003
Retrieve Notice of Action (NOA) 10/22/2003
This request, as amended by additional material dated 11-21-03 sent by Harold Ashner of PBGC, is approved.
  Inventory as of this Action Requested Previously Approved
11/30/2006 11/30/2006 01/31/2005
32,246 0 45,900
3,055 0 2,540
15,965,000 0 9,657,000

Administrators of PBGC-insured pension plans file PBGC premium forms with premium payments required under 29 USC 1307 and 29 CFR Part 4007, which also requires retention and production of records necessary to support premium filings. The forms identify payers and let PBGC verify premium computations and perform premium audits. The retained records facilitate audits. The certification of compliance with 29 USC 1311 and 29 CFR Part 4011 enables PBGC to verify compliance and select plans for audit where appropriate.

None
None


No

1
IC Title Form No. Form Name
Payment of Premiums (29 CFR Part 4007), Disclosure to Participants (29 CFR Part 4011) FORM-1, FORM-1-EZ, FORM-1-ES

  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 32,246 45,900 0 0 -13,654 0
Annual Time Burden (Hours) 3,055 2,540 0 0 515 0
Annual Cost Burden (Dollars) 15,965,000 9,657,000 0 0 6,308,000 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.
10/22/2003


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