Information Collection

Termination of Single Employer Plans

IC 13567 under ICR 201409-1212-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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	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

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 Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,430	0	0	1,430
Annual IC Time Burden (Hours)	1,708	41	0	1,667
Annual IC Cost Burden (Dollars)	1,721,391	41,300	-1,081,110	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.