Annual Information Return/Report

Forms and Documents

Document Name	Status
Form 5500 Annual Information Return/Report Form and Instruction	Unchanged
Final5500instructions2008.pdf Supplementary Document	2008-11-09
Justification for nonmaterial nonsubstantive change 10-30.doc Justification for No Material/Nonsubstantive Change	2008-10-30
85500a.pdf Supplementary Document	2008-10-14
2009 Form_5500_SF_70424 (2).pdf Supplementary Document	2008-10-09
2009 Form_5500_and_Schedules.pdf Supplementary Document	2008-10-09
Summary of Changes 2008.doc Supplementary Document	2008-10-06
8B5500SB.pdf Supplementary Document	2008-10-06
8B5500MB.pdf Supplementary Document	2008-10-06
85500ssa.pdf Supplementary Document	2008-10-06
85500r.pdf Supplementary Document	2008-10-06
85500i.pdf Supplementary Document	2008-10-06
85500h.pdf Supplementary Document	2008-10-06
85500ez.pdf Supplementary Document	2008-10-06
85500g.pdf Supplementary Document	2008-10-06
85500e.pdf Supplementary Document	2008-10-06
85500d.pdf Supplementary Document	2008-10-06
85500c.pdf Supplementary Document	2008-10-06
85500.pdf Supplementary Document	2008-10-06

IC Document Collections

IC ID	Document Title	Status
13467	Annual Information Return/Report Form and Instruction	Unchanged

ICR Details

OMB Control No: 1210-0110	ICR Reference No: 200807-1210-003
Status: Historical Active	Previous ICR Reference No: 200711-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Annual Information Return/Report
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/10/2008
	Date Received in OIRA: 11/10/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2010	09/30/2010	09/30/2010
Responses	780,000	0	780,000
Time Burden (Hours)	521,000	0	536,000
Cost Burden (Dollars)	190,000,000	0	195,000,000

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Abstract: Section 104 and 4065 of ERISA require plan administrators to file an annual report containing the information described in section 103 of ERISA. The Form 5500 provides a standard format for fulfilling that requirement.

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Authorizing Statute(s): US Code: 29 USC 1023 Name of Law: Employee Retirement Income Security Act of 1974
  

Citations for New Statutory Requirements: PL: Pub.L. 109 - 280 1103(b) Name of Law: Pension Protection Act of 2006

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB06	Final or interim final rulemaking	72 FR 64709	11/16/2007

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 41392	07/21/2006
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Information Return/Report	5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500, 5500	2009 Form 5500 and Instructions ,   2007 Form 5500 ,   2007 Form 5500 Schedule A ,   2007 Form 5500 Schedule B ,   2007 Form 5500 Schedule C ,   2007 Form 5500 Schedule D ,   2007 Form 5500 Schedule E ,   2007 Form 5500 Schedule EZ ,   2007 Form 5500 Schedule G ,   2007 Form 5500 Schedule H ,   2007 Form 5500 Schedule I ,   2007 Form 5500 Schedule R ,   2007 Form 5500 Schedule SSA

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ICR Summary of Burden

	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	780,000	780,000	0	0	0	0
Annual Time Burden (Hours)	521,000	536,000	-15,000	0	0	0
Annual Cost Burden (Dollars)	190,000,000	195,000,000	-5,000,000	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Pension Protection Act of 2006 required some new questions as well as a question for the total number of contributing employers for defined benefit plans and an asset allocation question on the Schedule R (Program Change Due to New Statute). One time transition costs for the new questions in 2007 were considered for 2007. In 2008, no transition costs were considered for items that were introduced in 2007, which is the main reason for the burden reduction. The simplified reporting alternative for certain small plans is still in place (Change in 2007).

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Annual Cost to Federal Government: $8,200,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/10/2008

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