Information Collection

Annual Information Return/Report

IC 13467 under ICR 201104-1210-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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
2011 Form 5500 Instructions - Mock Up.pdf	Instruction
2011 Form 5500-SF Instructions - Mock Up.pdf	Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan Form_5500_mockup.pdf	Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Form_5500-SF_mockup.pdf	Form
Form 5500- Schedul Insurance Information SchA_mockup.pdf	Form
Form 5500 -- Sched Service Provider Information SchC_mockup.pdf	Form
Form 5500 -- Sched DFE/Participating Plan Information SchD_mockup.pdf	Form
Form 5500 -- Sched Financial Transaction Schedules SchG_mockup.pdf	Form
Form 5500-- Schedu Financial Information SchH_mockup.pdf	Form
Form 5500 -- Sched Financial Information�Small Plan SchI_mockup.pdf	Form
Form 5500 -- Sched Multiemployer Defined Benefit Plan and Certain Money Pur SchMB_mockup.pdf	Form
Form 5500 -- Sched Retirement Plan Information SchR_mockup.pdf	Form
Form 5500- Schedul Single-Employer Defined Benefit Plan Actuarial Informati SchSB_mockup.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: 29 CFR 2520.103-1

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
Instruction			2011 Form 5500 Instructions - Mock Up.pdf	Yes	No	Printable Only
Instruction			2011 Form 5500-SF Instructions - Mock Up.pdf	Yes	No	Printable Only
Form	Form 5500	Annual Return/Report of Employee Benefit Plan	Form_5500_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	Short Form Annual Return/Report of Small Employee	Form_5500-SF_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500- Schedule A	Insurance Information	SchA_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule C	Service Provider Information	SchC_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule D	DFE/Participating Plan Information	SchD_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule G	Financial Transaction Schedules	SchG_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-- Schedule H	Financial Information	SchH_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule I	Financial Informationï¿½Small Plan	SchI_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule MB	Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information	SchMB_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 -- Schedule R	Retirement Plan Information	SchR_mockup.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 5500- Schedule SB	Single-Employer Defined Benefit Plan Actuarial Information	SchSB_mockup.pdf	Yes	Yes	Fillable Fileable Signable

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: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	780,000	0	780,000
Annual IC Time Burden (Hours)	520,000	-10,000	530,000
Annual IC Cost Burden (Dollars)	184,000,000	6,000,000	178,000,000

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.