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Annual Information Return/Report
Annual Information Return/Report
OMB: 1210-0110
IC ID: 13467
OMB.report
DOL/EBSA
OMB 1210-0110
ICR 200907-1210-001
IC 13467
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:
2024-04-02 - No material or nonsubstantive change to a currently approved collection
2023-12-18 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2010 Form 5500 and
Annual Information Return/Report
Form
2009SFInstructions.pdf
Instruction
20095500instructions.pdf
Instruction
2010Form 5500 No MB SBinstructions.pdf
Instruction
2010Form 5500-SFinstructions.pdf
Instruction
2010 Form 5500 and Annual Return/Report of Employee Benefit Plan and Short
2010 Forms and Schedules.pdf
Form
2009 Form 5500-SF Short Form Annual Return/Report of Small Employee
2009 Form_5500_SF_70424 (2).pdf
Form
Form 5500 Annual Return/Report of Employee Benefit Plan
2009 Form_5500_and_Schedules.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Information Return/Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
2010 Form 5500 and 2010 Form 5500-SF
Annual Return/Report of Employee Benefit Plan and Short Form Annual Return/Report of Small Employee
2010 Forms and Schedules.pdf
Yes
Yes
Fillable Fileable
Instruction
2009SFInstructions.pdf
Yes
Yes
Fillable Fileable
Instruction
20095500instructions.pdf
Yes
Yes
Fillable Fileable
Instruction
2010Form 5500 No MB SBinstructions.pdf
Yes
Yes
Fillable Fileable
Instruction
2010Form 5500-SFinstructions.pdf
Yes
Yes
Fillable Fileable
Form
2009 Form 5500-SF
Short Form Annual Return/Report of Small Employee
2009 Form_5500_SF_70424 (2).pdf
Yes
Yes
Fillable Fileable
Form
Form 5500
Annual Return/Report of Employee Benefit Plan
2009 Form_5500_and_Schedules.pdf
Yes
Yes
Fillable Fileable
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:
780,000
Number of Respondents for Small Entity:
630,000
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
1 %
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
780,000
0
0
0
0
780,000
Annual IC Time Burden (Hours)
530,000
0
9,000
0
0
521,000
Annual IC Cost Burden (Dollars)
178,000,000
0
-12,000,000
0
0
190,000,000
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.