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Qualified Domestic Relations Orders submitted to the PBGC
Qualified Domestic Relations Orders submitted to the PBGC
OMB: 1212-0054
IC ID: 43802
OMB.report
PBGC
OMB 1212-0054
ICR 200606-1212-001
IC 43802
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0054 can be found here:
2021-12-16 - Revision of a currently approved collection
2018-11-15 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
875
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
875
0
0
211
0
664
Annual IC Time Burden (Hours)
841
0
0
607
0
234
Annual IC Cost Burden (Dollars)
569,003
0
3
86,000
0
483,000
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.