Annual Return/Report of Employee Benefit Plan

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Sch SB (Form 5500) Single-Employer Defined Benefit Plan Actuarial Information (2014-Draft)	Form	Modified	Repair queued
Form Sch R (Form 5500) Retirement Plan Information (2014-Draft)	Form	Modified	Available
Form Sch MB (Form 5500) Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (2014-Draft)	Form	Modified	Available
Form Sch I (Form 5500) Financial Information—Small Plan (2014-Draft)	Form	Modified	Available
Form Sch H (Form 5500) Financial Information (2014-Draft)	Form	Modified	Available
Form Sch G (Form 5000) Financial Transaction Schedules (2014-Draft)	Form	Modified	Available
Form Sch D (Form 5500) DFE/Participating Plan Information (2014-Draft)	Form	Modified	Available
Form Sch C (Form 5500) Service Provider Information (2014-Draft)	Form	Modified	Available
Form Sch A (Form 5500) Insurance Information (2014-Draft)	Form	Modified	Available
Form Form 5500-SF Short Form Annual Return/Report of Small Employee Benefit Plan (2014-Draft)	Form	Modified	Available
Form Form 5500 Annual Return/Report of Employee Benefit Plan (2014-Draft)	Form	Modified	Available
Form Sch SB (Form 5500) Single-Employer Defined Benefit Plan Actuarial Information	Form	Modified	Available
Form Sch R (Form 5500) Retirement Plan Information	Form	Modified	Available
Form Sch MB (Form 5500) Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information	Form	Modified	Available
Form Sch I (Form 5500) Financial Information—Small Plan	Form	Modified	Available
Form Sch H (Form 5500) Financial Information	Form	Modified	Available
Form Sch G (Form 5500) Financial Transaction Schedules	Form	Modified	Available
Form Sch D (Form 5500) DFE/Participating Plan Information	Form	Modified	Available
Form Sch C (Form 5500) Service Provider Information	Form	Modified	Available
Form Sch A (Form 5500) Insurance Information	Form	Modified	Available
Form 5500SF Short Form Annual Return/Report of Small Employee Benefit Plan	Form	Modified	Available
Form 5500 Annual Return/Report of Employee Benefit Plan (2013)	Form	Modified	Available
2014 Supporting Statement.doc	Supporting Statement A	Uploaded 2014-03-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Single-Employer Defined Benefit Plan Actuarial Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Retirement Plan Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information—Small Plan (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Transaction Schedules (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	DFE/Participating Plan Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Service Provider Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Insurance Information (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Short Form Annual Return/Report of Small Employee Benefit Plan (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Annual Return/Report of Employee Benefit Plan (2014-Draft)
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Single-Employer Defined Benefit Plan Actuarial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Retirement Plan Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information—Small Plan
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Transaction Schedules
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	DFE/Participating Plan Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Service Provider Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Insurance Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Short Form Annual Return/Report of Small Employee Benefit Plan
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Annual Return/Report of Employee Benefit Plan (2013)
40957	Annual Return/Report of Employee Benefit Plan	Instruction	Modified

ICR Details

OMB Control No: 1545-1610	ICR Reference No: 201401-1545-001
Status: Historical Active	Previous ICR Reference No: 201305-1545-011
Agency/Subagency: TREAS/IRS	Agency Tracking No: KD-1610-001
Title: Annual Return/Report of Employee Benefit Plan
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/19/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/31/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved	05/31/2014
Responses	786,000	0	800,000
Time Burden (Hours)	319,000	0	326,000
Cost Burden (Dollars)	112,088,000	0	112,000,000

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Abstract: Form 5500 is an annual information return filed by employee benefit plans. The IRS uses this information to determine if the plan appears to be operating properly as required under the law or whether the plan should be audited.

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Authorizing Statute(s): US Code: 26 USC 6058 Name of Law: Information required in connection with certain plans of deferred compensation
   PL: Pub.L. 109 - 280 1 Name of Law: The Pension Protection Act of 2006 (PPA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 45615	07/29/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 5022	01/30/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Annual Return/Report of Employee Benefit Plan	Form 5500-SF, Sch A (Form 5500) , Sch C (Form 5500), Sch G (Form 5000) , Sch R (Form 5500), Sch H (Form 5500), Sch I (Form 5500), Sch MB (Form 5500), Sch SB (Form 5500), Form 5500, Sch D (Form 5500) , Sch A (Form 5500), Sch D (Form 5500), Sch R (Form 5500), Sch SB (Form 5500) , 5500SF, 5500, Sch C (Form 5500), Sch G (Form 5500), Sch H (Form 5500), Sch I (Form 5500), Sch MB (Form 5500)	Annual Return/Report of Employee Benefit Plan (2013) ,   Short Form Annual Return/Report of Small Employee Benefit Plan ,   Insurance Information ,   Service Provider Information ,   DFE/Participating Plan Information ,   Financial Transaction Schedules ,   Financial Information ,   Financial Information—Small Plan ,   Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information ,   Retirement Plan Information ,   Single-Employer Defined Benefit Plan Actuarial Information ,   Annual Return/Report of Employee Benefit Plan (2014-Draft) ,   Short Form Annual Return/Report of Small Employee Benefit Plan (2014-Draft) ,   Insurance Information (2014-Draft) ,   Service Provider Information (2014-Draft) ,   DFE/Participating Plan Information (2014-Draft) ,   Financial Transaction Schedules (2014-Draft) ,   Financial Information (2014-Draft) ,   Financial Information—Small Plan (2014-Draft) ,   Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (2014-Draft) ,   Retirement Plan Information (2014-Draft) ,   Single-Employer Defined Benefit Plan Actuarial Information (2014-Draft)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	786,000	800,000	0	-14,000	0	0
Annual Time Burden (Hours)	319,000	326,000	0	-7,000	0	0
Annual Cost Burden (Dollars)	112,088,000	112,000,000	0	88,000	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The Department has updated the hour and cost burden associated with the ICR to reflect its most recent data on Form 5500 filings and wage rates. The number of filings decreased, while the wage rates increased. The net effect of this was a decrease in the number of responses and the time burden, and an increase in the cost burden of $88,000.

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Annual Cost to Federal Government: $3,032,900

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/31/2014

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