Information Collection

Annual Information Return/Report

IC 13467 under ICR 201503-1210-003 · OMB 1210-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2015 Form 5500 Instructions - 150320 Clean Draft.doc	Instruction
2015 Form 5500 SF Instructions - 150320 Clean Draft.doc	Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan 150123 Clean Form5500.doc	Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi 150123 Clean Form5500SF.doc	Form
Form 5500 Schedule Insurance Information 150123 Clean SchA.doc	Form
Form 5500 Schedule Service Provider Information 150123 Clean SchC.doc	Form
Form 5500 Schedule DFE/Participating Plan Information 150123 Clean SchD.doc	Form
Form 5500 Schedule Financial Transaction Schedules 150123 Clean SchG.doc	Form
Form 5500 Schedule Financial Information 150123 Clean SchH.doc	Form
Form 5500 Schedule Financial Information--Small Plans 150123 Clean SchI.doc	Form
Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Pu 150128 Clean SchMB.doc	Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati 150123 Clean SchSB.doc	Form
Form 5500 Schedule Retirement Plan Information 150123 Clean SchR.doc	Form
2015 Form 5500 Instructions - 150320 RLSO Draft.doc Form 5500 Instructions (Red Line)	IC Document
2015 Form 5500 SF Instructions - 150320 RLSO Draft.doc Form 5500-SF Instructions (Red Line)	IC Document
150123 RLSO Form5500.doc Form 5500 (Red Line)	IC Document
150123 RLSO Form5500SF.doc Form 5500-SF (Red Line)	IC Document
150123 RLSO SchA.doc Form 5500 Schedule A (Red Line)	IC Document
150123 RLSO SchC.doc Form 5500 Schedule C (Red Line)	IC Document
150123 RLSO SchD.doc Form 5500 Schedule D (Red Line)	IC Document
150123 RLSO SchG.doc Form 5500 Schedule G (Red Line)	IC Document
150123 RLSO SchH.doc Form 5500 Schedule H (Red Line)	IC Document
150123 RLSO SchI.doc Form 5500 Schedule I (Red Line)	IC Document
150128 RLSO SchMB.doc Form 5500 Schedule MB (Red Line)	IC Document
150123 RLSO SchSB.doc Form 5500 Schedule SB (Red Line)	IC Document
150123 RLSO SchR.doc Form 5500 Schedule R (Red Line)	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 2520.103-1

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			2015 Form 5500 Instructions - 150320 Clean Draft.doc	Yes	Yes	Fillable Fileable
Instruction			2015 Form 5500 SF Instructions - 150320 Clean Draft.doc	Yes	Yes	Fillable Fileable
Form	Form 5500	Annual Return/Report of Employee Benefit Plan	150123 Clean Form5500.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	Short Form Annual Return/Report of Small Employee Benefit Plan	150123 Clean Form5500SF.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule A	Insurance Information	150123 Clean SchA.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule C	Service Provider Information	150123 Clean SchC.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule D	DFE/Participating Plan Information	150123 Clean SchD.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule G	Financial Transaction Schedules	150123 Clean SchG.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule H	Financial Information	150123 Clean SchH.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule I	Financial Information--Small Plans	150123 Clean SchI.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule MB	Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information	150128 Clean SchMB.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule SB	Single-Employer Defined Benefit Plan Actuarial Information	150123 Clean SchSB.doc	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule R	Retirement Plan Information	150123 Clean SchR.doc	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: 822,000

Number of Respondents for Small Entity: 668,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	822,000	36,000	786,000
Annual IC Time Burden (Hours)	579,000	24,000	555,000
Annual IC Cost Burden (Dollars)	229,368,000	10,450,000	218,918,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form 5500 Instructions (Red Line)	2015 Form 5500 Instructions - 150320 RLSO Draft.doc	03/30/2015
Form 5500-SF Instructions (Red Line)	2015 Form 5500 SF Instructions - 150320 RLSO Draft.doc	03/30/2015
Form 5500 (Red Line)	150123 RLSO Form5500.doc	03/30/2015
Form 5500-SF (Red Line)	150123 RLSO Form5500SF.doc	03/30/2015
Form 5500 Schedule A (Red Line)	150123 RLSO SchA.doc	03/30/2015
Form 5500 Schedule C (Red Line)	150123 RLSO SchC.doc	03/30/2015
Form 5500 Schedule D (Red Line)	150123 RLSO SchD.doc	03/30/2015
Form 5500 Schedule G (Red Line)	150123 RLSO SchG.doc	03/30/2015
Form 5500 Schedule H (Red Line)	150123 RLSO SchH.doc	03/30/2015
Form 5500 Schedule I (Red Line)	150123 RLSO SchI.doc	03/30/2015
Form 5500 Schedule MB (Red Line)	150128 RLSO SchMB.doc	03/30/2015
Form 5500 Schedule SB (Red Line)	150123 RLSO SchSB.doc	03/30/2015
Form 5500 Schedule R (Red Line)	150123 RLSO SchR.doc	03/30/2015

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