Information Collection

Settlement Agreements Between a Plan and Party in Interest

IC 13416 under ICR 201202-1210-005 · OMB 1210-0091.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0091 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PTE 94-71.doc	Other-PTE 94-71
pte 2003-39.pdf	Other-PTE 2003-39

IC Title:

Settlement Agreements Between a Plan and Party in Interest

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Other-PTE 94-71			PTE 94-71.doc		Yes	No	Printable Only
Other-PTE 2003-39			pte 2003-39.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: 4

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 38 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,080	0	1,080
Annual IC Time Burden (Hours)	30	2	28
Annual IC Cost Burden (Dollars)	335	20	315

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.