Information Collection

Annual Information Return/Report of Employee Benefit Plan

IC 13467 under ICR 201610-1210-001 · OMB 1210-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
IRS and DOL Changes (Clean) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.doc	Instruction
IRS and DOL Changes (Clean) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.doc	Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan 160205 Clean Form 5500.docx	Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi 160927 Clean Form 5500SF.docx	Form
Form 5500 Schedule Insurance Information 160205 Clean Sch A.docx	Form
Form 5500 Schedule Service Provider Information 160205 Clean Sch C.docx	Form
Form 5500 Schedule DFE/Participating Plan Information 160205 Clean Sch D.docx	Form
Form 5500 Schedule Financial Transaction Schedules 160205 Clean Sch G.docx	Form
Form 5500 Schedule Financial Information 160205 Clean Sch H.docx	Form
Form 5500 Schedule Financial Information--Small Plans 160205 Clean Sch I.docx	Form
Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Pu 160205 Clean Sch MB.docx	Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati 160205 Clean Sch SB.docx	Form
Form 5500 Schedule Retirement Plan Information 160205 Clean Sch R.docx	Form
IRS and DOL Changes (RLSO) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.doc Form 5500 Instructions (Red Line)	IC Document
IRS and DOL Changes (RLSO) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.doc Form 5500-SF Instructions (Red Line)	IC Document
160205 RLSO Form 5500.docx Form 5500 (Red Line)	IC Document
160927 RLSO Form 5500SF.docx Form 5500-SF (Red Line)	IC Document
160205 RLSO Sch A.docx Schedule A (Red Line)	IC Document
160205 RLSO Sch C.docx Schedule C (Red Line)	IC Document
160205 RLSO Sch D.docx Schedule D (Red Line)	IC Document
160205 RLSO Sch G.docx Schedule G (Red Line)	IC Document
160205 RLSO Sch H.docx Schedule H (Red Line)	IC Document
160205 RLSO Sch I.docx Schedule I (Red Line)	IC Document
160205 RLSO Sch MB.docx Schedule MB (Red Line)	IC Document
160205 RLSO Sch SB.docx Schedule SB (Red Line)	IC Document
160205 RLSO Sch R.docx Schedule R (Red Line)	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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			IRS and DOL Changes (Clean) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.doc	Yes	Yes	Fillable Fileable
Instruction			IRS and DOL Changes (Clean) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.doc	Yes	Yes	Fillable Fileable
Form	Form 5500	Annual Return/Report of Employee Benefit Plan	160205 Clean Form 5500.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	Short Form Annual Return/Report of Small Employee Benefit Plan	160927 Clean Form 5500SF.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule A	Insurance Information	160205 Clean Sch A.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule C	Service Provider Information	160205 Clean Sch C.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule D	DFE/Participating Plan Information	160205 Clean Sch D.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule G	Financial Transaction Schedules	160205 Clean Sch G.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule H	Financial Information	160205 Clean Sch H.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule I	Financial Information--Small Plans	160205 Clean Sch I.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule MB	Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information	160205 Clean Sch MB.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule SB	Single-Employer Defined Benefit Plan Actuarial Information	160205 Clean Sch SB.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule R	Retirement Plan Information	160205 Clean Sch R.docx	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: 806,000

Number of Respondents for Small Entity: 658,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	806,000	0	-16,000	822,000
Annual IC Time Burden (Hours)	550,000	0	-29,000	579,000
Annual IC Cost Burden (Dollars)	232,879,999	-1	3,512,000	229,368,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form 5500 Instructions (Red Line)	IRS and DOL Changes (RLSO) on 2016 Form 5500 Instructions (based on version 160713) 9-29-16.doc	10/12/2016
Form 5500-SF Instructions (Red Line)	IRS and DOL Changes (RLSO) on 2016 Form 5500SF Instruction (Based on version 160713) 9-29-2016.doc	10/12/2016
Form 5500 (Red Line)	160205 RLSO Form 5500.docx	10/12/2016
Form 5500-SF (Red Line)	160927 RLSO Form 5500SF.docx	10/12/2016
Schedule A (Red Line)	160205 RLSO Sch A.docx	10/12/2016
Schedule C (Red Line)	160205 RLSO Sch C.docx	10/12/2016
Schedule D (Red Line)	160205 RLSO Sch D.docx	10/12/2016
Schedule G (Red Line)	160205 RLSO Sch G.docx	10/12/2016
Schedule H (Red Line)	160205 RLSO Sch H.docx	10/12/2016
Schedule I (Red Line)	160205 RLSO Sch I.docx	10/12/2016
Schedule MB (Red Line)	160205 RLSO Sch MB.docx	10/12/2016
Schedule SB (Red Line)	160205 RLSO Sch SB.docx	10/12/2016
Schedule R (Red Line)	160205 RLSO Sch R.docx	10/12/2016

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