Annual Information Return/Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5500 Annual Information Return/Report	Form	Modified	Repair queued
85500i.pdf	Supplementary Document	Uploaded 2008-11-07	Available
08i5500hilite1107FinCumChgs1029sgmlCir1030.pdf	Supplementary Document	Uploaded 2008-11-07	Available
Justification for nonmaterial nonsubstantive change 10-30.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2008-11-03	Available
85500h.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500g.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500ez.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500e.pdf	Supplementary Document	Uploaded 2008-10-14	Repair queued
85500d.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500c.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500.pdf	Supplementary Document	Uploaded 2008-10-14	Available
8B5500SB.pdf	Supplementary Document	Uploaded 2008-10-14	Available
8B5500MB.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500r.pdf	Supplementary Document	Uploaded 2008-10-14	Available
85500a.pdf	Supplementary Document	Uploaded 2008-10-14	Repair queued
85500ssa.pdf	Supplementary Document	Uploaded 2008-10-14	Available
PBGC 2009F5500ss07.d6.pdf	Supporting Statement A	Uploaded 2008-10-10	Repair queued
Form_5500_SF_70424.pdf	Supplementary Document	Uploaded 2007-07-17	Available
Form_5500_and_Schedules.pdf	Supplementary Document	Uploaded 2007-07-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13607	Annual Information Return/Report	Form	Modified

ICR Details

OMB Control No: 1212-0057	ICR Reference No: 200807-1212-003
Status: Historical Active	Previous ICR Reference No: 200705-1212-001
Agency/Subagency: PBGC	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:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2010	09/30/2010	09/30/2010
Responses	30,300	0	30,300
Time Burden (Hours)	2,000	0	1,800
Cost Burden (Dollars)	1,830,000	0	1,600,000

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

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Authorizing Statute(s): US Code: 29 USC 1302(b)(3), 1365 Name of Law: ERISA
  

Citations for New Statutory Requirements: Statute at Large: 120 Stat. 780 Name of Statute: 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	71 FR 41392	07/21/2006

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 41616	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

table that charts list of burden

IC Title	Form No.	Form Name
Annual Information Return/Report	5500, 5500-SF	Annual Return/Report of Employee Benefit Plan ,   Short Form Annual Return/Report of Small Employee Benefit Plan

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ICR Summary of Burden

table that charts list 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	30,300	30,300	0	0	0	0
Annual Time Burden (Hours)	2,000	1,800	200	0	0	0
Annual Cost Burden (Dollars)	1,830,000	1,600,000	230,000	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. Overall the burden hours and associated costs increased slightly in 2008 to reflect some new questions as a result of the replacement of Schedule B with Schedules MB and SB (Program Change due to New Statute). The simplified reporting alternative for certain small plans is still in place (Change in 2007).

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Annual Cost to Federal Government: $400,000

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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