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Termination of Single Employer Plans
Termination of Single Employer Plans
OMB: 1212-0036
IC ID: 13567
OMB.report
PBGC
OMB 1212-0036
ICR 201409-1212-001
IC 13567
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0036 can be found here:
2024-09-25 - No material or nonsubstantive change to a currently approved collection
2023-10-20 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Standard termination instructions 2014 Final.docx
Instruction
Distress Termination instructions 2014 Final.docx
Instruction
MP_instructions 2014 Final.docx
Instruction
Forms 500 to 501 Standard termination forms
Standard termination forms 2014 Final.docx
Form
Forms 600 to 602 Distress termination forms
Distress Termination forms 2014 Final.docx
Form
Schedule MP (missi Schedule MP
Schedule MP forms 2014 Final.docx
Form
Supporting Statement 2014 Final.docx
Supporting Statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
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 4050
29 CFR 4041
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Standard termination instructions 2014 Final.docx
Yes
No
Printable Only
Form
Forms 500 to 501
Standard termination forms
Standard termination forms 2014 Final.docx
Yes
No
Fillable Printable
Instruction
Distress Termination instructions 2014 Final.docx
Yes
No
Printable Only
Form
Forms 600 to 602
Distress termination forms
Distress Termination forms 2014 Final.docx
Yes
No
Printable Only
Instruction
MP_instructions 2014 Final.docx
Yes
No
Printable Only
Form
Schedule MP (missing participant)
Schedule MP
Schedule MP forms 2014 Final.docx
Yes
No
Printable Only
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:
1,430
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,430
0
0
0
0
1,430
Annual IC Time Burden (Hours)
1,708
0
41
0
0
1,667
Annual IC Cost Burden (Dollars)
1,721,391
0
41,300
-1,081,110
0
2,761,201
Documents for IC
Title
Document
Date Uploaded
Supporting Statement
Supporting Statement 2014 Final.docx
10/20/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.