Information Collection

Annual Information Return/Report of Employee Benefit Plan

IC 13467 under ICR 201703-1210-001 · OMB 1210-0110.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
2017 Form 5500 Instructions CLEAN 032317.doc Instruction
2017 Form 5500SF Instruction CLEAN 032317.doc Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan
170203 Clean Form 5500.docx
Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi
170203 Clean Form 5500SF.docx
Form
Form 5500 Schedule Insurance Information
170203 Clean Sch A.docx
Form
Form 5500 Schedule Service Provider Information
170203 Clean Sch C.docx
Form
Form 5500 Schedule DFE/Participating Plan Information
170203 Clean Sch D.docx
Form
Form 5500 Schedule Financial Transaction Schedules
170203 Clean Sch G.docx
Form
Form 5500 Schedule Financial Information
170203 Clean Sch H.docx
Form
Form 5500 Schedule Financial Information--Small Plans
170203 Clean Sch I.docx
Form
Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Pu
170203 Clean Sch MB.docx
Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati
170203 Clean Sch SB.docx
Form
Form 5500 Schedule Retirement Plan Information
170203 Clean Sch R.docx
Form
2017 Form 5500 Instructions RLSO 032317.doc
Form 5500 Instructions (Red Line)
IC Document
2017 Form 5500SF Instruction RLSO 032317.doc
Form 5500-SF Instructions (Red Line)
IC Document
170203 RLSO Form 5500.docx
Form 5500 (Red Line)
IC Document
170203 RLSO Form 5500SF.docx
Form 5500-SF (Red Line)
IC Document
170203 RLSO Sch A.docx
Schedule A (Red Line)
IC Document
170203 RLSO Sch C.docx
Schedule C (Red Line)
IC Document
170203 RLSO Sch D.docx
Schedule D (Red Line)
IC Document
170203 RLSO Sch G.docx
Schedule G (Red Line)
IC Document
170203 RLSO Sch H.docx
Schedule H (Red Line)
IC Document
170203 RLSO Sch I.docx
Schedule I (Red Line)
IC Document
170203 RLSO Sch MB.docx
Schedule MB (Red Line)
IC Document
170203 RLSO Sch SB.docx
Schedule SB (Red Line)
IC Document
170203 RLSO Sch R.docx
Schedule R (Red Line)
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 2017 Form 5500 Instructions CLEAN 032317.doc Yes Yes Fillable Fileable
Instruction 2017 Form 5500SF Instruction CLEAN 032317.doc Yes Yes Fillable Fileable
Form Form 5500 Annual Return/Report of Employee Benefit Plan 170203 Clean Form 5500.docx Yes Yes Fillable Fileable Signable
Form Form 5500-SF Short Form Annual Return/Report of Small Employee Benefit Plan 170203 Clean Form 5500SF.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule A Insurance Information 170203 Clean Sch A.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule C Service Provider Information 170203 Clean Sch C.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule D DFE/Participating Plan Information 170203 Clean Sch D.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule G Financial Transaction Schedules 170203 Clean Sch G.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule H Financial Information 170203 Clean Sch H.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule I Financial Information--Small Plans 170203 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 170203 Clean Sch MB.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule SB Single-Employer Defined Benefit Plan Actuarial Information 170203 Clean Sch SB.docx Yes Yes Fillable Fileable Signable
Form Form 5500 Schedule R Retirement Plan Information 170203 Clean Sch R.docx Yes Yes Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 828,000 0 0 22,000 0 806,000
Annual IC Time Burden (Hours) 583,000 0 0 33,000 0 550,000
Annual IC Cost Burden (Dollars) 266,073,000 0 0 33,193,001 0 232,879,999

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Form 5500 Instructions (Red Line) 2017 Form 5500 Instructions RLSO 032317.doc 03/28/2017
Form 5500-SF Instructions (Red Line) 2017 Form 5500SF Instruction RLSO 032317.doc 03/28/2017
Form 5500 (Red Line) 170203 RLSO Form 5500.docx 03/28/2017
Form 5500-SF (Red Line) 170203 RLSO Form 5500SF.docx 03/28/2017
Schedule A (Red Line) 170203 RLSO Sch A.docx 03/28/2017
Schedule C (Red Line) 170203 RLSO Sch C.docx 03/28/2017
Schedule D (Red Line) 170203 RLSO Sch D.docx 03/28/2017
Schedule G (Red Line) 170203 RLSO Sch G.docx 03/28/2017
Schedule H (Red Line) 170203 RLSO Sch H.docx 03/28/2017
Schedule I (Red Line) 170203 RLSO Sch I.docx 03/28/2017
Schedule MB (Red Line) 170203 RLSO Sch MB.docx 03/28/2017
Schedule SB (Red Line) 170203 RLSO Sch SB.docx 03/28/2017
Schedule R (Red Line) 170203 RLSO Sch R.docx 03/28/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.