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Voluntary Fiduciary Correction Program
Voluntary Fiduciary Correction Program
OMB: 1210-0118
IC ID: 13494
OMB.report
DOL/EBSA
OMB 1210-0118
ICR 200805-1210-005
IC 13494
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0118 can be found here:
2022-03-16 - Extension without change of a currently approved collection
2019-03-01 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
CleanversionrevisedModel Application 4 11 06.doc
Other-Clean Version of Revised Model
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Voluntary Fiduciary Correction Program
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-Clean Version of Revised Model Application
CleanversionrevisedModel Application 4 11 06.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,250
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
38 %
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
11,790
0
0
0
0
11,790
Annual IC Time Burden (Hours)
5,625
0
0
0
0
5,625
Annual IC Cost Burden (Dollars)
109,000
0
0
0
0
109,000
Documents for IC
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.