Form 200_SupStmt_2012 ROLLOVER_to OMB

SUPPORTING STATEMENT FOR REQUEST FOR OMB APPROVAL
UNDER THE PAPERWORK REDUCTION ACT AND 5 CFR PART 1320

AGENCY:

Pension Benefit Guaranty Corporation

TITLE:

PBGC Form 200, Notice of Failure to Make Required Contributions
(29 CFR § 4043.81)

STATUS:

Request for renewal of a currently approved collection of information (OMB
control no. 1212-0041; expires March 31, 2012)

CONTACT: James Bloch (202-326-4000, ext. 3530) or Catherine Klion (202-326-4000,
ext. 3041)
A.

Justification.
1. Need for collection. Section 303(k) of the Employee Retirement Income Security Act

of 1974 (ERISA) and section 430(k) of the Internal Revenue Code of 1986 (Code) impose a lien
in favor of an underfunded single-employer plan that is covered by PBGC’s termination
insurance program if (1) any person fails to make a required payment when due, and (2) the
unpaid balance of that payment (including interest), when added to the aggregate unpaid balance
of all preceding payments for which payment was not made when due (including interest),
exceeds $1 million. (For this purpose, a plan is underfunded if its funding target attainment
percentage is less than 100 percent.) The lien is upon all property and rights to property
belonging to the person or persons that are liable for required contributions (i.e., a contributing
sponsor and each member of the controlled group of which that contributing sponsor is a
member).
Only PBGC (or, at its direction, the plan's contributing sponsor or a member of the same
controlled group) may perfect and enforce this lien. ERISA and the Code require persons that
fail to make payments to notify PBGC within 10 days of the due date whenever there is a failure

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to make a required payment and the total of the unpaid balances (including interest) exceeds $1
million.
PBGC Form 200, Notice of Failure to Make Required Contributions, and related filing
instructions implement the statutory notification requirement. Submission of Form 200 is
required by 29 CFR § 4043.81.
2. Use of information. PBGC uses the information it obtains to make decisions
regarding enforcement of liens created under ERISA section 303(k)(1) and Code section
430(k)(1). This information enables PBGC staff to determine the amount of the statutory lien
and to evaluate the funding status of the plan and the financial condition of the person(s)
responsible for its funding. Without this information, PBGC could not efficiently and effectively
use the statutory lien provisions in carrying out its responsibilities to protect plan benefits and
control insurance program costs.
3. Use of technological collection techniques. PBGC permits Form 200 filings to be
made by electronic transmission to the address specified in the filing instructions on PBGC’s
Web site.
4. Duplication and similar information. PBGC avoids potential duplication by
permitting a filer to respond to an item that calls for documentation or other information
previously submitted to PBGC (in an earlier Form 200 or another context) by identifying the
previous submission in which the response was provided.
In addition, to the extent that PBGC staff can use information from documents prepared
for other purposes (including reports and other filings with Federal agencies and in judicial
proceedings) in lien-enforcement decision making, Form 200 calls for the submission of copies
of those documents.

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A failure that triggers this notification requirement also may be a reportable event (see
ERISA section 4043(c)(5) and 29 CFR § 4043.25). The reportable event notice requirement is
satisfied if a timely and complete Form 200 is submitted with respect to the same failure (see
29 CFR § 4043.25(d)).
PBGC believes that there is no information similar to that required under the regulation
that could be used instead of the required information for the purposes served by the regulation.
5. Small businesses. Not applicable. This information collection does not have a
significant economic impact on a substantial number of small entities.
6. Consequences of no or less frequent collection. ERISA establishes when PBGC
collects information by requiring that PBGC be notified of each failure to make a required
funding payment by the due date. If PBGC were notified less frequently, or not at all, it would
not have the information that it needs to make timely lien-enforcement decisions.
7. Special Circumstances. The statutory notification requirement is tied to the minimum
funding standards, under which payments may be made more often than quarterly.
Consequently, failure to make a required payment may trigger the statutory notification
requirement more often than quarterly.
Under ERISA and the Code, a person must notify PBGC within 10 days of a payment
due date whenever there is a failure to make a required payment and the total of the unpaid
balances (including interest) exceeds $1 million. A person must use PBGC Form 200 for this
notification (29 CFR § 4043.81). Persons that may be required to notify PBGC can familiarize
themselves with Form 200, and even begin preparing responses, before a payment failure that
triggers the statutory notification requirement. In some cases, PBGC may require the submission
of additional information. In general, the submission of additional information is required within

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7 days after PBGC makes a written request. The 7-day period is necessary to ensure that PBGC
has sufficient time to act to enforce the statutory liens. Any delay may result in financial loss to
PBGC (see item 2). In addition, PBGC may shorten the time period for responding to a written
request for additional information, but only where it determines that the interests of PBGC or
participants may be prejudiced by a delay in the receipt of the information.
In all other respects, this collection of information is not conducted in any manner
described in item 7 of the general instructions for the supporting statement.
8. Outside input. On December 8, 2011, PBGC published a notice (76 FR 76771)
soliciting public comment on this collection of information pursuant to 5 CFR § 1320.8(d). No
public comments were received in response to the notice.
9. Payments and Gifts. PBGC provides no payments or gifts to respondents in
connection with this collection of information.
10. Confidentiality. In accordance with 29 CFR § 4901.21(a)(3), any information or
documentary material that is submitted to PBGC pursuant to section 4043 is exempt from
disclosure under the Freedom of Information Act (5 U.S.C. 552) (FOIA) and will not be made
public, except as may be relevant to an administrative or judicial action or proceeding. (FOIA
section 552(d) does not prevent disclosure to Congress or to an authorized congressional
committee or subcommittee.)
11. Sensitive questions. This collection of information involves no questions of a
personal nature.
12. Burden on the public. PBGC anticipates that over the next three years this
collection-of-information requirement will apply, annually, to 111 single-employer plans. PBGC
estimates that the average response time for the filing will be 6 hours. This time is an average

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that will vary depending on the nature and organizational structure of persons liable for plan
contributions (in particular, whether the plan’s contributing sponsor is a member of a controlled
group and, if so, the size of that group) and on the funding history of the plan.
PBGC estimates that over the next three years the total annual burden on the public will
be 666 hours (111 filings times 6 hours per filing). Assuming an average rate of $320 (including
professional time, support assistance, overhead, postage and other costs) for large plans (i.e.,
plans with greater than 100 participants), and an average rate of $130 for small plans (i.e., plans
with less than or equal to 100 participants), PBGC estimates that the dollar equivalent of the hour
burden would be an annual total cost of $204,000, for an average annual cost of $1,840 per
respondent.
13. Costs. PBGC estimates that over the next three years, respondents will contract out
an additional 333 hours annually (111 filings times 3 hours per filing). Assuming an average
rate of $320 for large plans’ contractor costs and $130 for small plans’ contractor costs, PBGC
estimates that the total annual cost under the Form 200 for purchase of services will be $102,000,
for an average annual cost of $920 per respondent. No capital or start-up costs are necessary for
the Form 200 notice.
14. Costs to the Federal government. PBGC estimates that over the next three years the
total annual cost to it for processing filings will be about $13,100, based upon an estimated
annual hour burden of 222 hours — 111 filings times 2 hours per filing (0.25 hours of clerical
staff time plus 1.75 hours of professional staff time) — and an estimated hourly cost of $59
(blended rate based on administrative staff costs of $44 an hour and professional staff costs of
$61 an hour).

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15. Change in burden. The changes in burden and cost are the result of a decrease in the
number of expected filings based upon PBGC’s experience in the last three years, and a revised
estimate (based on a small survey of practitioners) in the hourly contracting rate from $350 for
all plans to $320 for large plans and $130 for small plans. In addition, in light of the small
number of filings, PBGC eliminated the assumption that when there is a subsequent payment
failure and a subsequent filing due from the same filer, the average response time for the
subsequent filing would be less.
16. Publication plans. PBGC does not plan to publish the results of this collection of
information.
17. Approval for omitting expiration date. Not applicable. PBGC is not seeking OMB
approval to omit the expiration date.
18. Exceptions to certification statement. There are no exceptions to the certification
statement for this submission.

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