Administrative Appeals

ICR 201604-1212-001

OMB: 1212-0061

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2016-05-03
IC Document Collections
ICR Details
1212-0061 201604-1212-001
Historical Active 201302-1212-004
PBGC
Administrative Appeals
Extension without change of a currently approved collection   No
Regular
Approved without change 08/29/2016
Retrieve Notice of Action (NOA) 05/09/2016
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 08/31/2016
900 0 900
643 0 643
46,680 0 46,680

The PBGC’s regulation on Rules for Administrative Review of Agency Decisions prescribes rules governing the issuance of initial determinations by the PBGC and the procedures for requesting and obtaining administrative review of initial determinations. For those types of initial determinations subject to administrative appeals, the regulation prescribes rules on who may file appeals, when and where to file appeals, contents of appeals, and other matters relating to appeals. Most appeals filed with the PBGC are filed by individuals (participants, beneficiaries, and alternate payees) in connection with benefit entitlement or amounts. A small number of appeals are filed by employers in connection with other matters, such as plan coverage or employer liability. Appeals may be filed by hand, mail, commercial delivery service, fax or e-mail. For appeals of benefit determinations, the PBGC has developed new optional forms for filing appeals and requests for extensions of time to appeal.

US Code: 29 USC 1303 Name of Law: ERISA
  
None

Not associated with rulemaking

  81 FR 10289 02/29/2016
81 FR 28109 05/09/2016
No

  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 900 900 0 0 0 0
Annual Time Burden (Hours) 643 643 0 0 0 0
Annual Cost Burden (Dollars) 46,680 46,680 0 0 0 0
No
No

$45,000
No
No
No
No
No
Uncollected
Donald McCabe 202-326-4223 ext. 3872 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/09/2016


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