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Annual Information Return/Report of Employee Benefit Plan
Annual Information Return/Report of Employee Benefit Plan
OMB: 1210-0110
IC ID: 13467
OMB.report
DOL/EBSA
OMB 1210-0110
ICR 201604-1210-001
IC 13467
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:
2025-04-14 - No material or nonsubstantive change to a currently approved collection
2024-04-02 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
5500 NPFR (clean).docx
Notice of Proposed Forms Revisions
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Information Return/Report of Employee Benefit Plan
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
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:
2,967,500
Number of Respondents for Small Entity:
2,810,118
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
2,967,500
0
2,145,500
0
0
822,000
Annual IC Time Burden (Hours)
1,030,000
0
451,000
0
0
579,000
Annual IC Cost Burden (Dollars)
490,022,000
0
260,654,000
0
0
229,368,000
Documents for IC
Title
Document
Date Uploaded
Notice of Proposed Forms Revisions
5500 NPFR (clean).docx
06/17/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.