Information Collection

Annual Information Return/Report

IC 13607 under ICR 200908-1212-001 · OMB 1212-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2010 5500 and 2010 Annual Information Return/Report	Form
2010 5500 and 2010 2010 Annual Return/Report of Employee Benefit Plan and 2 Attachment D - 2010 Forms and Schedules.pdf	Form
2009 5500 and 2010 2009 Annual Return/Report of Employee Benefit Plan and 2 Attachment D - 2009 Forms 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: 29 CFR 4065

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
Form	2010 5500 and 2010 5500-SF	2010 Annual Return/Report of Employee Benefit Plan and 2010 Short Form Annual Return/Report of Small Employee Benefit Plan	Attachment D - 2010 Forms and Schedules.pdf		Yes	Yes	Fillable Fileable
Form	2009 5500 and 2010 5500-SF	2009 Annual Return/Report of Employee Benefit Plan and 2009 Short Form Annual Return/Report of Small Employee Benefit Plan	Attachment D - 2009 Forms 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: 30,300

Number of Respondents for Small Entity: 18,300

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	30,300	0	30,300
Annual IC Time Burden (Hours)	1,200	-800	2,000
Annual IC Cost Burden (Dollars)	1,250,000	-580,000	1,830,000

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.