Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Form and Instruction	Modified	Repair queued
4010supportingstatement.doc	Supporting Statement A	Uploaded 2009-02-06	Available
justification.120607.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2007-12-06	Available
TechUpdate 07-2.rev.2OMB.doc	Supplementary Document	Uploaded 2007-12-06	Available
justification.4010PRA.d2.dcm.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2007-11-27	Available
TechUpdate v2 d27.doc	Supplementary Document	Uploaded 2007-11-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13583	Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Form and Instruction	Modified

ICR Details

OMB Control No: 1212-0049	ICR Reference No: 200901-1212-002
Status: Historical Inactive	Previous ICR Reference No: 200802-1212-012
Agency/Subagency: PBGC	Agency Tracking No:
Title: Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 02/10/2009
	Date Received in OIRA: 02/09/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: ERISA section 4010 requires the annual reporting of actuarial and financial information by controlled groups that sponsor pension plans that have significant underfunding. PBGC uses this information to detect and monitor financial problems with the controlled groups and to respond quickly when it learns that a controlled group intends to engage in a transaction that may reduce the assets available to pay plan liabilities.

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Authorizing Statute(s): US Code: 29 USC 1310 Name of Law: ERISA
  

Citations for New Statutory Requirements: PL: Pub.L. 109 - 280 505 Name of Law: Pension Protection Act of 2006

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1212-AB09	Final or interim final rulemaking	73 FR 9243	02/20/2008

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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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 Financial and Actuarial Information Reporting (29 CFR Part 4010)	NA, NA, N/A, N/A	4010 screen shots (pre-PPA) ,   4010 (pre-PPA) ,   4010 (PPA) ,   4010 Screenshots (PPA)

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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:

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Annual Cost to Federal Government: $22,300

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: 02/09/2009

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