Information Collection

Annual Information Return/Report

IC 13467 under ICR 200907-1210-001 · OMB 1210-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	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

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	780,000	0	780,000
Annual IC Time Burden (Hours)	530,000	9,000	521,000
Annual IC Cost Burden (Dollars)	178,000,000	-12,000,000	190,000,000

Documents for IC

table that charts IC Documents
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.