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Annual Information Return/Report
Annual Information Return/Report
OMB: 1212-0057
IC ID: 13607
OMB.report
PBGC
OMB 1212-0057
ICR 201607-1212-001
IC 13607
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:
2024-04-03 - No material or nonsubstantive change to a currently approved collection
2023-02-27 - Revision of a currently approved collection
Documents and Forms
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:
Document Type
Form No.
Form Name
Instrument File
URL
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 %
Approved
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
24,000
0
0
0
0
24,000
Annual IC Time Burden (Hours)
1,200
0
0
0
0
1,200
Annual IC Cost Burden (Dollars)
1,465,000
0
0
58,000
0
1,407,000
Documents for IC
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.