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Federal forms, ICRs, and supporting documents

Information Collection

Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits

IC 9597 under ICR 200708-0960-012 · OMB 0960-0606.

Documents and Forms
Document Name
Document Type
Other-Information Exchange Agreement
Other-IRS's Privacy Safeguards, Disc
Other-IRS Requirements on Behalf of
Other-IRS EPMF Extract File for SSA
Instruction
Instruction
Other-MOU/IEA Agreement
Form
Information Collection (IC) Details

View Information Collection (IC)

Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Information Exchange Agreement IEA IRS-SSA.doc Yes Yes Fillable Fileable Signable
Other-IRS's Privacy Safeguards, Disclosure Safeguards, Record Retention and Security Attachment A.doc No   Printable Only
Other-IRS Requirements on Behalf of SSA with DOL's Processing Contract Attachment B.doc No   Printable Only
Other-IRS EPMF Extract File for SSA (sample) Attachment C - IRS EPMF Extract File for SSA.doc Yes Yes Fillable Fileable Signable
Form Form 5500 (IRS Form) Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits (Schedule SSA) Schedule SSA Form.pdf http://www.efast.dol.gov/ Yes Yes Fillable Fileable Signable
Instruction 2007 Instructions for Schedule SSA.pdf Yes No Printable Only
Instruction EFAST & Paper Instructions for Form 5500.pdf Yes Yes Printable Only
Other-MOU/IEA Agreement Signed IEA IRS-SSA 11-07.doc No   Paper Only

Income Security General Retirement and Disability

 

88,000 0
   
Private Sector Businesses or other for-profits
 
   50 %

  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 88,000 0 0 0 0 88,000
Annual IC Time Burden (Hours) 220,000 0 0 0 0 220,000
Annual IC Cost Burden (Dollars) 12,194,000 0 0 0 0 12,194,000

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.