Annual Information Return/Report

OMB: 1210-0110

IC ID: 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⚠️ Notice: This information collection may be referencing outdated material.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
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:

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 Information�Small 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 %

	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

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.