Notice of Insolvency (29 CFR Part 4245)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 2 Notice of Insolvency (29 CFR Part 4245)	Form	Modified	Available
multi 0033 2ROCIS 08062015c.docx	Supporting Statement A	Uploaded 2015-09-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13555	Notice of Insolvency (29 CFR Part 4245)	Form	Modified

ICR Details

OMB Control No: 1212-0033	ICR Reference No: 201509-1212-005
Status: Historical Active	Previous ICR Reference No: 201402-1212-004
Agency/Subagency: PBGC	Agency Tracking No:
Title: Notice of Insolvency (29 CFR Part 4245)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/24/2015
	Date Received in OIRA: 09/18/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2018	36 Months From Approved	06/30/2017
Responses	2,598	0	2,598
Time Burden (Hours)	1	0	1
Cost Burden (Dollars)	723	0	1,788

---

Abstract: These notices, mandated by section 4245(e) of the Employee Retirement Income Security Act of 1974 and 29 CFR Part 2674, provide information PBGC needs to estimate cash requirements for financial assistance to troubled mutliemployer pension plans, and other interested parties need for financial planning or to bargain over contribution increases. Multiemployer plans in reorganization that are or may become insolvent give these notices.

---

Authorizing Statute(s): US Code: 29 USC 1441 Name of Law: ERISA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1212-AB28	Final or interim final rulemaking	80 FR 55742	09/17/2015

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Notice of Insolvency (29 CFR Part 4245)	Form 1, Form 2	Insolvency Notice

---

ICR Summary of Burden

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	2,598	2,598	0	0	0	0
Annual Time Burden (Hours)	1	1	0	0	0	0
Annual Cost Burden (Dollars)	723	1,788	0	-825	-240	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $558

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/18/2015

---