Information Collection

Qualified Domestic Relations Orders Submitted to the PBGC

IC 13595 under ICR 200310-1212-003 · OMB 1212-0054.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Qualified Domestic Relations Orders Submitted to the PBGC

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of 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: 664

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	664	364	300
Annual IC Time Burden (Hours)	234	130	104
Annual IC Cost Burden (Dollars)	483,000	364,000	119,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.