Information Collection

Annual Information Return/Report

IC 13607 under ICR 201402-1212-012 · OMB 1212-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2014 Form 5500 Instructions - 140314 Clean Draft.pdf	Instruction
2014 Form 5500 Instructions RLSO - 140314.pdf	Instruction
2014 Form 5500 SF Instructions - 140314 Clean Draft.pdf	Instruction
2014 Form 5500 SF Instructions RLSO - 140314.pdf	Instruction
2014 Form 5500 2014 Annual Return/Report of Employee Benefit Plan 140124 Clean Form5500.pdf	Form
2014 Form 5500 2014 Annual Return/Report of Employee Benefit Plan (Redl 140124 RLSO Form5500.pdf	Form
2014 Form 5500-SF 2014 Short Form Annual Return/Report of Small Employee B 140124 Clean Form5500SF.pdf	Form
2014 Form 5500-SF 2014 Short Form Annual Return/Report of Small Employee B 140124 RLSO Form5500SF.pdf	Form
2014 Schedule A (F 2014 Schedule A (Form 5500) - Insurance Information 140124 Clean SchA.pdf	Form
2014 Schedule A (F 2014 Schedule A (Form 5500) - Insurance Information (Red 140124 RLSO SchA.pdf	Form
2014 Schedule C (F 2014 Schedule C (Form 5500) - Service Provider Informati 140124 Clean SchC.pdf	Form
2014 Schedule C (F 2014 Schedule C (Form 5500) - Service Provider Informati 140124 RLSO SchC.pdf	Form
2014 Schedule D (F 2014 Schedule D (Form 5500) - DFE/Participating Provider 140124 Clean SchD.pdf	Form
2014 Schedule D (F 2014 Schedule D (Form 5500) - DFE/Participating Provider 140124 RLSO SchD.pdf	Form
2014 Schedule G (F 2014 Schedule G (Form 5500) - Financial Transaction Sche 140124 Clean SchG.pdf	Form
2014 Schedule G (F 2014 Schedule G (Form 5500) - Financial Transaction Sche 140124 RLSO SchG.pdf	Form
2014 Schedule H (F 2014 Schedule H (Form 5500) - Financial Information 140124 Clean SchH.pdf	Form
2014 Schedule H (F 2014 Schedule H (Form 5500) - Financial Information (Red 140124 RLSO SchH.pdf	Form
2014 Schedule I (F 2014 Schedule I (Form 5500) - Financial Information - Sm 140124 Clean SchI.pdf	Form
2014 Schedule I (F 2014 Schedule I (Form 5500) - Financial Information - Sm 140124 RLSO SchI.pdf	Form
2014 Schedule MB ( 2014 Schedule MB (Form 5500) - Multiemployer Defined Ben 140124 Clean SchMB.pdf	Form
2014 Schedule MB ( 2014 Schedule MB (Form 5500) - Multiemployer Defined Ben 140124 RLSO SchMB.pdf	Form
2014 Schedule R (F 2014 Schedule R (Form 5500) - Retirement Plan Informatio 140124Clean SchR.pdf	Form
2014 Schedule R (F 2014 Schedule R (Form 5500) - Retirement Plan Informatio 140124 RLSO SchR.pdf	Form
2014 Schedule SB ( 2014 Schedule SB (Form 5500) - Single-Employer Defined B 140124 Clean SchSB.pdf	Form
2014 Schedule SB ( 2014 Schedule SB (Form 5500) - Single-Employer Defined B 140124 RLSO SchSB.pdf	Form
Annual-Reporting-Form-5500-Series-Comment BFA.pdf 5500 Comment - BFA	IC Document

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2014 Form 5500 SF Instructions RLSO - 140314.pdf	Yes	Yes	Fillable Fileable
Form	2014 Schedule R (Form 5500)	2014 Schedule R (Form 5500) - Retirement Plan Information (Redline/Strikeout)	140124 RLSO SchR.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2014 Form 5500 Instructions - 140314 Clean Draft.pdf	Yes	Yes	Fillable Fileable
Instruction			2014 Form 5500 Instructions RLSO - 140314.pdf	Yes	Yes	Fillable Fileable
Instruction			2014 Form 5500 SF Instructions - 140314 Clean Draft.pdf	Yes	Yes	Fillable Fileable
Form	2014 Form 5500	2014 Annual Return/Report of Employee Benefit Plan	140124 Clean Form5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Form 5500	2014 Annual Return/Report of Employee Benefit Plan (Redline/Strikeout)	140124 RLSO Form5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Form 5500-SF	2014 Short Form Annual Return/Report of Small Employee Benefit Plan	140124 Clean Form5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Form 5500-SF	2014 Short Form Annual Return/Report of Small Employee Benefit Plan (Redline/Strikeout)	140124 RLSO Form5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule A (Form 5500)	2014 Schedule A (Form 5500) - Insurance Information	140124 Clean SchA.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule A (Form 5500)	2014 Schedule A (Form 5500) - Insurance Information (Redline/Strikeout)	140124 RLSO SchA.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule C (Form 5500)	2014 Schedule C (Form 5500) - Service Provider Information	140124 Clean SchC.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule C (Form 5500)	2014 Schedule C (Form 5500) - Service Provider Information (Redline/Strikeout)	140124 RLSO SchC.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule D (Form 5500)	2014 Schedule D (Form 5500) - DFE/Participating Provider Information	140124 Clean SchD.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule D (Form 5500)	2014 Schedule D (Form 5500) - DFE/Participating Provider Information (Redline/Strikeout)	140124 RLSO SchD.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule G (Form 5500)	2014 Schedule G (Form 5500) - Financial Transaction Schedules	140124 Clean SchG.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule G (Form 5500)	2014 Schedule G (Form 5500) - Financial Transaction Schedules (Redline/Strikeout)	140124 RLSO SchG.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule H (Form 5500)	2014 Schedule H (Form 5500) - Financial Information	140124 Clean SchH.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule H (Form 5500)	2014 Schedule H (Form 5500) - Financial Information (Redline/Strikeout)	140124 RLSO SchH.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule I (Form 5500)	2014 Schedule I (Form 5500) - Financial Information - Small Plan	140124 Clean SchI.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule I (Form 5500)	2014 Schedule I (Form 5500) - Financial Information - Small Plan (Redlne/Strikeout)	140124 RLSO SchI.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule MB (Form 5500)	2014 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information	140124 Clean SchMB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule MB (Form 5500)	2014 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (Redline/Strikeout)	140124 RLSO SchMB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule R (Form 5500)	2014 Schedule R (Form 5500) - Retirement Plan Information	140124Clean SchR.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule SB (Form 5500)	2014 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information	140124 Clean SchSB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2014 Schedule SB (Form 5500)	2014 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (Redline/Strikeout)	140124 RLSO SchSB.pdf	Yes	Yes	Fillable Fileable Signable

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: 25,000

Number of Respondents for Small Entity: 17,500

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 1 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,000	-5,300	30,300
Annual IC Time Burden (Hours)	1,200	0	1,200
Annual IC Cost Burden (Dollars)	1,357,000	-6,000	1,363,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
5500 Comment - BFA	Annual-Reporting-Form-5500-Series-Comment BFA.pdf	04/18/2014

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