Information Collection

Notice of Blackout Period Under ERISA

IC 13502 under ICR 200904-1210-002 · OMB 1210-0122.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0122 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
blackout09frn.pdf 60-day Federal Register Notice	IC Document

IC Title:

Notice of Blackout Period Under ERISA

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2520.101-3

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45,218

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 38 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,465,447	-1,934,553	5,400,000
Annual IC Time Burden (Hours)	183,342	-4,344	187,686
Annual IC Cost Burden (Dollars)	1,628,760	221,760	1,407,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
60-day Federal Register Notice	blackout09frn.pdf	04/02/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.