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Annual Information Return/Report
Annual Information Return/Report
OMB: 1210-0110
IC ID: 13467
OMB.report
DOL/EBSA
OMB 1210-0110
ICR 201203-1210-005
IC 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⚠️ Notice: This information collection may be referencing outdated material.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
Form Form 5500 Schedule
Annual Information Return/Report
Form
2012 Form 5500 Instructions - 120126 Red Line Draft.pdf
Instruction
2012 Form 5500 SF Instructions - 120126 Red Line Draft.pdf
Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan
120126 Red Line Form5500.pdf
Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi
120126 Red Line Form5500SF.pdf
Form
Form 5500 Schedule Insurance Information
120126 Red Line SchA.pdf
Form
Form 5500 Schedule Service Provider Information
120126 Red Line SchC.pdf
Form
Form 5500 Schedule DFE/Participating Plan Information
120126 Red Line SchD.pdf
Form
Form 5500 Schedule Financial Transaction Schedules
120126 Red Line SchG.pdf
Form
Form 5500 Schedule Financial Information
120126 Red Line SchH.pdf
Form
Form 5500 Schedule Financial InformationSmall Plan
120126 Red Line SchI.pdf
Form
Form 5500 Schedule Multiemployer Defined Benefit Plan and Certain Money Pur
120126 Red Line SchMB.pdf
Form
Form 5500 Schedule Retirement Plan Information
120126 Red Line SchR.pdf
Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati
120126 Red Line SchSB.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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Form 5500 Schedule H
Financial Information
120126 Red Line SchH.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule I
Financial InformationSmall Plan
120126 Red Line SchI.pdf
Yes
Yes
Fillable Fileable Signable
Instruction
2012 Form 5500 Instructions - 120126 Red Line Draft.pdf
Yes
Yes
Fillable Printable
Instruction
2012 Form 5500 SF Instructions - 120126 Red Line Draft.pdf
Yes
Yes
Fillable Printable
Form
Form 5500
Annual Return/Report of Employee Benefit Plan
120126 Red Line Form5500.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500-SF
Short Form Annual Return/Report of Small Employee Benefit Plan
120126 Red Line Form5500SF.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule A
Insurance Information
120126 Red Line SchA.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule C
Service Provider Information
120126 Red Line SchC.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule D
DFE/Participating Plan Information
120126 Red Line SchD.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule G
Financial Transaction Schedules
120126 Red Line SchG.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule MB
Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
120126 Red Line SchMB.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule R
Retirement Plan Information
120126 Red Line SchR.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500 Schedule SB
Single-Employer Defined Benefit Plan Actuarial Information
120126 Red Line SchSB.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
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
780,000
0
0
0
0
780,000
Annual IC Time Burden (Hours)
520,000
0
0
0
0
520,000
Annual IC Cost Burden (Dollars)
184,000,000
0
0
0
0
184,000,000
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.