Information Collection

Reportable Events

IC 13522 under ICR 201302-1212-001 · OMB 1212-0013.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0013 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10 Reportable Events	Form and Instruction
10 Post-Event Notice of Reportable Events Form 10 and Instructions_Proposed Rule.2omb.2013rule.pdf www.pbgc.gov/documents/10.pdf	Form and Instruction
10-ADV Advance Notice of Reportable Events Form 10 ADV and Instructions_Proposed Rule_to OMB.2013rule.pdf www.pbgc.gov/Documents/10_A.pdf	Form and Instruction

IC Title:

Reportable Events

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Form and Instruction	10	Post-Event Notice of Reportable Events	Form 10 and Instructions_Proposed Rule.2omb.2013rule.pdf	http://www.pbgc.gov/documents/10.pdf	Yes	Yes	Fillable Printable
Form and Instruction	10-ADV	Advance Notice of Reportable Events	Form 10 ADV and Instructions_Proposed Rule_to OMB.2013rule.pdf	http://www.pbgc.gov/Documents/10_A.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,085

Number of Respondents for Small Entity: 286

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,085	59	1,026
Annual IC Time Burden (Hours)	5,740	340	5,400
Annual IC Cost Burden (Dollars)	857,195	35,369	821,826

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.