Information Collection

Termination of Single Employer Plans

IC 13567 under ICR 201110-1212-001 · OMB 1212-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Standard Termination Instructions 2011 Final.docx	Instruction
Distress Termination Instructions 2011 Final.docx	Instruction
MP_instructions.pdf www.pbgc.gov/Documents/MP_instructions_092804.pdf	Instruction
500-501 Standard termination forms Form 500-501.pdf www.pbgc.gov/documents/500and501.pdf	Form
Forms 600-602 Distress termination forms Form 600-602.pdf www.pbgc.gov/Documents/600-601-602.pdf	Form
Schedule MP Schedule MP Schedule MP.pdf www.pbgc.gov/Documents/mp_form_092804.pdf	Form

IC Title:

Termination of Single Employer Plans

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4041 29 CFR 4050

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
Instruction			Standard Termination Instructions 2011 Final.docx		Yes	No	Printable Only
Form	500-501	Standard termination forms	Form 500-501.pdf	http://www.pbgc.gov/documents/500and501.pdf	Yes	Yes	Fillable Printable
Instruction			Distress Termination Instructions 2011 Final.docx		Yes	No	Printable Only
Form	Forms 600-602	Distress termination forms	Form 600-602.pdf	http://www.pbgc.gov/Documents/600-601-602.pdf	Yes	No	Printable Only
Instruction			MP_instructions.pdf	http://www.pbgc.gov/Documents/MP_instructions_092804.pdf	Yes	No	Printable Only
Form	Schedule MP	Schedule MP	Schedule MP.pdf	http://www.pbgc.gov/Documents/mp_form_092804.pdf	Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,379

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,379	1,379
Annual IC Time Burden (Hours)	2,161	2,161
Annual IC Cost Burden (Dollars)	3,098,441	3,098,441

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.