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Annual Information Return/Report
Annual Information Return/Report
OMB: 1212-0057
IC ID: 13607
OMB.report
PBGC
OMB 1212-0057
ICR 201203-1212-001
IC 13607
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:
2024-04-03 - No material or nonsubstantive change to a currently approved collection
2023-02-27 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Form 5500
Annual Information Return/Report
Form
2012 Form 5500 SF Instructions - 120126 Clean Draft.pdf
Instruction
2012 Form 5500 SF Instructions - 120126 Clean Draft.pdf
Instruction
2012 Form 5500 Instructions - 120126 Red Line Draft.pdf
Instruction
2012 Form 5500 SF Instructions - 120126 Red Line Draft.pdf
Instruction
Form 5500 2012 Annual Return/Report of Employee Benefit Plan
120126 Clean Form5500.pdf
Form
Form 5500-SF 2012 Short Form Annual Return/Report of Small Employee B
120126 Clean Form5500SF.pdf
Form
Schedule A (Form 5 2012 Schedule A (Form 5500) - Insurance Information
120126 Clean SchA.pdf
Form
Schedule C (Form 5 2012 Schedule C (Form 5500) - Service Provider Informati
120126 Clean SchC.pdf
Form
Schedule D (Form 5 2012 Schedule D (Form 5500) - DFE/Participating Plan Inf
120126 Clean SchD.pdf
Form
Schedule G (Form 5 2012 Schedule G (Form 5500) - Financial Transaction Sche
120126 Clean SchG.pdf
Form
Schedule H (Form 5 2012 Schedule H ( Form 5500) - Financial Information
120126 Clean SchH.pdf
Form
Schedule I (Form 5 2012 Schedule I (Form 5500) - Financial Information - Sm
120126 Clean SchI.pdf
Form
Schedule MB (Form 2012 Schedule MB (Form 5500) - Multiemployer Defined Ben
120126 Clean SchMB.pdf
Form
Schedule R (Form 5 2012 Schedule R (Form 5500) - Retirement Plan Informatio
120126 Clean SchR.pdf
Form
Schedule SB (Form 2012 Schedule B (Form 5500) - Single-Employer Defined Be
120126 Clean SchSB.pdf
Form
Form 5500 2012 Form 5500 Annual Return/Report of Employee Benefit
120126 Red Line Form5500.pdf
Form
Form 5500-SF 2012 Form 5500-SF Short Form Annual Return/Report of Emp
120126 Red Line Form5500SF.pdf
Form
Schedule A (Form 5 2012 Schedule A (Form 5500) - Insurance Information (Red
120126 Red Line SchA.pdf
Form
Schedule C (Form 5 2012 Schedule C (Form 5500) - Service Provider Informati
120126 Red Line SchC.pdf
Form
Schedule D (Form 5 2012 Schedule D (Form 5500) - DFE/Participating Plan Inf
120126 Red Line SchD.pdf
Form
Schedule G (Form 5 2012 Schedule G (Form 5500) - Financial Transaction Sche
120126 Red Line SchG.pdf
Form
Schedule H (Form 5 2012 Schedule H (Form 5500) - Financial Information (Red
120126 Red Line SchH.pdf
Form
Schedule I (Form 5 2012 Schedule I (Form 5500) - Financial Information - Sm
120126 Red Line SchI.pdf
Form
Schedule MB (Form 2012 Schedule MB (Form 5500) - Multiemployer Defined Ben
120126 Red Line SchMB.pdf
Form
Schedule R (Form 5 2012 Schedule R (Form 5500) - Retirement Plan Informatio
120126 Red Line SchR.pdf
Form
Schedule SB (Form 2012 Schedule SB (Form 5500) - Single-Employer Defined B
110923 Red Line SchSB.doc
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 4065
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Form 5500
2012 Annual Return/Report of Employee Benefit Plan
120126 Clean Form5500.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500-SF
2012 Short Form Annual Return/Report of Small Employee Benefit Plan
120126 Clean Form5500SF.pdf
Yes
Yes
Fillable Fileable Signable
Form
Schedule A (Form 5500)
2012 Schedule A (Form 5500) - Insurance Information
120126 Clean SchA.pdf
Yes
Yes
Fillable Fileable
Form
Schedule C (Form 5500)
2012 Schedule C (Form 5500) - Service Provider Information
120126 Clean SchC.pdf
Yes
Yes
Fillable Fileable
Form
Schedule D (Form 5500)
2012 Schedule D (Form 5500) - DFE/Participating Plan Information
120126 Clean SchD.pdf
Yes
Yes
Fillable Fileable
Form
Schedule G (Form 5500)
2012 Schedule G (Form 5500) - Financial Transaction Schedules
120126 Clean SchG.pdf
Yes
Yes
Fillable Fileable
Form
Schedule H (Form 5500)
2012 Schedule H ( Form 5500) - Financial Information
120126 Clean SchH.pdf
Yes
Yes
Fillable Fileable
Form
Schedule I (Form 5500)
2012 Schedule I (Form 5500) - Financial Information - Small Plan
120126 Clean SchI.pdf
Yes
Yes
Fillable Fileable
Form
Schedule MB (Form 5500)
2012 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
120126 Clean SchMB.pdf
Yes
Yes
Fillable Fileable
Form
Schedule R (Form 5500)
2012 Schedule R (Form 5500) - Retirement Plan Information
120126 Clean SchR.pdf
Yes
Yes
Fillable Fileable
Form
Schedule SB (Form 5500)
2012 Schedule B (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information
120126 Clean SchSB.pdf
Yes
Yes
Fillable Fileable
Instruction
2012 Form 5500 SF Instructions - 120126 Clean Draft.pdf
Yes
Yes
Fillable Fileable
Instruction
2012 Form 5500 SF Instructions - 120126 Clean Draft.pdf
Yes
Yes
Fillable Fileable
Form
Form 5500
2012 Form 5500 Annual Return/Report of Employee Benefit Plan (Redline)
120126 Red Line Form5500.pdf
Yes
Yes
Fillable Fileable Signable
Form
Form 5500-SF
2012 Form 5500-SF Short Form Annual Return/Report of Employee Benefit Plan (Redline)
120126 Red Line Form5500SF.pdf
Yes
Yes
Fillable Fileable Signable
Form
Schedule A (Form 5500)
2012 Schedule A (Form 5500) - Insurance Information (Redline)
120126 Red Line SchA.pdf
Yes
Yes
Fillable Fileable
Form
Schedule C (Form 5500)
2012 Schedule C (Form 5500) - Service Provider Information (Redline)
120126 Red Line SchC.pdf
Yes
Yes
Fillable Fileable
Form
Schedule D (Form 5500)
2012 Schedule D (Form 5500) - DFE/Participating Plan Information (Redline)
120126 Red Line SchD.pdf
Yes
Yes
Fillable Fileable
Form
Schedule G (Form 5500)
2012 Schedule G (Form 5500) - Financial Transaction Schedules (Redline)
120126 Red Line SchG.pdf
Yes
Yes
Fillable Fileable
Form
Schedule H (Form 5500)
2012 Schedule H (Form 5500) - Financial Information (Redline)
120126 Red Line SchH.pdf
Yes
Yes
Fillable Fileable
Form
Schedule I (Form 5500)
2012 Schedule I (Form 5500) - Financial Information - Small Plan (Redline)
120126 Red Line SchI.pdf
Yes
Yes
Fillable Fileable
Form
Schedule MB (Form 5500)
2012 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (Redline)
120126 Red Line SchMB.pdf
Yes
Yes
Fillable Fileable
Form
Schedule R (Form 5500)
2012 Schedule R (Form 5500) - Retirement Plan Information (Redline)
120126 Red Line SchR.pdf
Yes
Yes
Fillable Fileable
Form
Schedule SB (Form 5500)
2012 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (Redline)
110923 Red Line SchSB.doc
Yes
Yes
Fillable Fileable
Instruction
2012 Form 5500 Instructions - 120126 Red Line Draft.pdf
Yes
Yes
Fillable Fileable
Instruction
2012 Form 5500 SF Instructions - 120126 Red Line Draft.pdf
Yes
Yes
Fillable Fileable
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:
30,300
Number of Respondents for Small Entity:
18,300
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
1 %
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
30,300
0
0
0
0
30,300
Annual IC Time Burden (Hours)
1,200
0
0
0
0
1,200
Annual IC Cost Burden (Dollars)
1,210,000
0
0
0
0
1,210,000
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.