Information Collection

Termination of Single Employer Plans

IC 13567 under ICR 201211-1212-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Distress termination instructions Final 2012.docx	Instruction
Standard termination instructions Final 2012 revised.docx	Instruction
Justification no material changes revised 12-2012.doc Justification no material changes	IC Document

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			Distress termination instructions Final 2012.docx		Yes	No	Printable Only
Instruction			Standard termination instructions Final 2012 revised.docx		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
	Approved	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
Justification no material changes	Justification no material changes revised 12-2012.doc	12/11/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.