Information Collection Request

Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

ICR 201504-1212-001 · OMB 1212-0049 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
4010supportingstatement2015 4_29_15 Rev 7_14_15.docx Supporting Statement A Uploaded 2015-07-14 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13583 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2018 36 Months From Approved 07/31/2015
200 0 300
1,748 0 2,620
3,392,000 0 5,088,000





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table that charts list of burden
IC Title Form No. Form Name
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) e-4010, e-4010 e-4010 Screenshots ,   e-4010 Form

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 200 300 0 0 -100 0
Annual Time Burden (Hours) 1,748 2,620 0 0 -872 0
Annual Cost Burden (Dollars) 3,392,000 5,088,000 0 0 -1,696,000 0


Reginfo record details
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