Information Collection

Annual Information Return/Report

IC 13607 under ICR 201607-1212-001 · OMB 1212-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2016 Form 5500 Annual Information Return/Report	Form
IRS and DOL Changes (Clean) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.pdf	Instruction
IRS and DOL Changes (RLSO) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.pdf	Instruction
IRS and DOL Changes (Clean) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.pdf	Instruction
IRS and DOL Changes (RLSO) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.pdf	Instruction
2016 Form 5500 2016 Annual Return/Report of Employee Benefit Plan (Clea 160205 Clean Form 5500.pdf	Form
2016 Form 5500-SF 2016 Short Form Annual Return/Report of Small Employee B 160927 Clean Form 5500SF.pdf	Form
2016 Form 5500 2016 Annual Return/Report of Employee Benefit Plan (RLSO 160205 RLSO Form 5500.pdf	Form
2016 Form 5500-SF 2016 Short Form Annual Return/Report of Small Employee B 160927 RLSO Form 5500SF.pdf	Form
2016 Schedule A (F 2016 Schedule A (Form 5500) - Insurance Information (Cle 160205 Clean Sch A.pdf	Form
2016 Schedule A (F 2016 Schedule A (Form 5500) - Insurance Information (RLS 160205 RLSO Sch A.pdf	Form
2016 Schedule C (F 2016 Schedule C (Form 5500) - Service Provider Informati 160205 Clean Sch C.pdf	Form
2016 Schedule C (F 2016 Schedule C (Form 5500) - Service Provider Informati 160205 RLSO Sch C.pdf	Form
2016 Schedule D (F 2016 Schedule D (Form 5500 - DFE/Participating Plan Info 160205 Clean Sch D.pdf	Form
2016 Schedule D (F 2016 Schedule D (Form 5500) - DFE/Participating Plan Inf 160205 RLSO Sch D.pdf	Form
2016 Schedule G (F 2016 Schedule G (Form 5500) - Financial Transaction Sche 160205 Clean Sch G.pdf	Form
2016 Schedule G (F 2016 Schedule G (Form 5500) - Financial Transaction Sche 160205 RLSO Sch G.pdf	Form
2016 Schedule H (F 2016 Schedule H (Form 5500) - Financial Information (Cle 160205 Clean Sch H.pdf	Form
2016 Schedule H (F 2016 Schedule H (Form 5500) - Financial Information (RLS 160205 RLSO Sch H.pdf	Form
2016 Schedule I (F 2016 Schedule I (Form 5500) - Financial Information - Sm 160205 Clean Sch I.pdf	Form
2016 Schedule I (F 2016 Schedule I (Form 5500) - Financial Information - Sm 160205 RLSO Sch I.pdf	Form
2016 Schedule MB ( 2016 Schedule MB (Form 5500) - Multiemployer Defined Ben 160205 Clean Sch MB.pdf	Form
2016 Schedule MB ( 2016 Schedule MB (Form 5500) - Multiemployer Defined Ben 160205 RLSO Sch MB.pdf	Form
2016 Schedule R (F 2016 Schedule R (Form 5500) - Retirement Plan Informatio 160205 Clean Sch R.pdf	Form
2016 Schedule R (F 2016 Schedule R (Form 5500) - Retirement Plan Informatio 160205 RLSO Sch R.pdf	Form
2016 Schedule SB ( 2016 Schedule SB (Form 5500) - Single-Employer Defined B 160205 Clean Sch SB.pdf	Form
2016 Schedule SB ( 2016 Schedule SB (Form 5500) - Single-Employer Defined B 160205 RLSO Sch SB.pdf	Form

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 4065

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
Form	2016 Form 5500	2016 Annual Return/Report of Employee Benefit Plan (Clean)	160205 Clean Form 5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Form 5500-SF	2016 Short Form Annual Return/Report of Small Employee Benefit Plan (Clean)	160927 Clean Form 5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Form 5500	2016 Annual Return/Report of Employee Benefit Plan (RLSO)	160205 RLSO Form 5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Form 5500-SF	2016 Short Form Annual Return/Report of Small Employee Benefit Plan (RLSO)	160927 RLSO Form 5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule A (Form 5500)	2016 Schedule A (Form 5500) - Insurance Information (Clean)	160205 Clean Sch A.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule A (Form 5500)	2016 Schedule A (Form 5500) - Insurance Information (RLSO)	160205 RLSO Sch A.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule C (Form 5500)	2016 Schedule C (Form 5500) - Service Provider Information (Clean)	160205 Clean Sch C.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule C (Form 5500)	2016 Schedule C (Form 5500) - Service Provider Information (RLSO)	160205 RLSO Sch C.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule D (Form 5500)	2016 Schedule D (Form 5500 - DFE/Participating Plan Information (Clean)	160205 Clean Sch D.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule D (Form 5500)	2016 Schedule D (Form 5500) - DFE/Participating Plan Information (RLSO)	160205 RLSO Sch D.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule G (Form 5500)	2016 Schedule G (Form 5500) - Financial Transaction Schedules (Clean)	160205 Clean Sch G.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule G (Form 5500)	2016 Schedule G (Form 5500) - Financial Transaction Schedules (RLSO)	160205 RLSO Sch G.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule H (Form 5500)	2016 Schedule H (Form 5500) - Financial Information (Clean)	160205 Clean Sch H.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule H (Form 5500)	2016 Schedule H (Form 5500) - Financial Information (RLSO)	160205 RLSO Sch H.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule I (Form 5500)	2016 Schedule I (Form 5500) - Financial Information - Small Plan (Clean)	160205 Clean Sch I.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule I (Form 5500)	2016 Schedule I (Form 5500) - Financial Information - Small Plan (RLSO)	160205 RLSO Sch I.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule MB (Form 5500)	2016 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (Clean)	160205 Clean Sch MB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule MB (Form 5500)	2016 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (RLSO)	160205 RLSO Sch MB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule R (Form 5500)	2016 Schedule R (Form 5500) - Retirement Plan Information (Clean)	160205 Clean Sch R.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule R (Form 5500)	2016 Schedule R (Form 5500) - Retirement Plan Information (RLSO)	160205 RLSO Sch R.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule SB (Form 5500)	2016 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (Clean)	160205 Clean Sch SB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2016 Schedule SB (Form 5500)	2016 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (RLSO)	160205 RLSO Sch SB.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			IRS and DOL Changes (Clean) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			IRS and DOL Changes (RLSO) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			IRS and DOL Changes (Clean) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			IRS and DOL Changes (RLSO) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.pdf	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: 24,000

Number of Respondents for Small Entity: 17,500

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 1 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	24,000	0	24,000
Annual IC Time Burden (Hours)	1,200	0	1,200
Annual IC Cost Burden (Dollars)	1,465,000	58,000	1,407,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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