Information Collection

Annual Information Return/Report

IC 13607 under ICR 201703-1212-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 2017 Form 5500 Annual Information Return/Report	Form
2017 Form 5500 Instructions CLEAN 032317.pdf	Instruction
2017 Form 5500SF Instruction CLEAN 032317.pdf	Instruction
2017 Form 5500 Instructions RLSO 032317.pdf	Instruction
2017 Form 5500SF Instruction RLSO 032317.pdf	Instruction
2017 Form 5500 2017 Annual Return/Report of Employee Benefit Plan (Clea 170203 Clean Form 5500.pdf	Form
2017 Form 5500-SF 2017 Short Form Annual Return/Report of Small Employee B 170203 Clean Form 5500SF.pdf	Form
2017 Schedule A (F 2017 Schedule A (Form 5500) - Insurance Information (Cle 170203 Clean Sch A.pdf	Form
2017 Schedule C (F 2017 Schedule C (Form 5500) - Service Provider Informati 170203 Clean Sch C.pdf	Form
2017 Schedule D (F 2017 Schedule D (Form 5500) - DFE/Participating Plan Inf 170203 Clean Sch D.pdf	Form
2017 Schedule G (F 2017 Schedule G (Form 5500) - Financial Transaction Sche 170203 Clean Sch G.pdf	Form
2017 Schedule H (F 2017 Schedule H (Form 5500) - Financial Information (Cle 170203 Clean Sch H.pdf	Form
2017 Schedule I (F 2017 Schedule I (Form 5500) - Financial Information - Sm 170203 Clean Sch I.pdf	Form
2017 Schedule MB ( 2017 Schedule MB (Form 5500) - Multiemployer Defined Ben 170203 Clean Sch MB.pdf	Form
2017 Schedule R (F 2017 Schedule R (Form 55) - Retirement Plan Information 170203 Clean Sch MB.pdf	Form
2017 Schedule SB ( 2017 Schedule SB (Form 5500) - Single-Employer Defined B 170203 Clean Sch SB.pdf	Form
2017 Form 5500 2017 Annual Return/Report of Employee Benefit Plan (RLSO 170203 RLSO Form 5500.pdf	Form
2017 Form 5500-SF 2017 Short Form Annual Return/Report of Small Employee B 170203 RLSO Form 5500SF.pdf	Form
2017 Schedule A (F 2017 Schedule A (Form 5500) - Insurance Information (RLS 170203 RLSO Sch A.pdf	Form
2017 Schedule C (F 2017 Schedule C (Form 5500) - Service Provider Informati 170203 RLSO Sch C.pdf	Form
2017 Schedule D (F 2017 Schedule D (Form 5500) - DFE/Participating Plan Inf 170203 RLSO Sch D.pdf	Form
2017 Schedule G (F 2017 Schedule G (Form 5500) - Financial Transaction Sche 170203 RLSO Sch G.pdf	Form
2017 Schedule H (F 2017 Schedule H (Form 5500) - Financial Information (RLS 170203 RLSO Sch H.pdf	Form
2017 Schedule I (F 2017 Schedule I (Form 5500) - Financial Information - Sm 170203 RLSO Sch I.pdf	Form
2017 Schedule MB ( 2017 Schedule MB (Form 5500) - Multiemployer Defined Ben 170203 RLSO Sch MB.pdf	Form
2017 Schedule R (F 2017 Schedule R (Form 55) - Retirement Plan Information 170203 RLSO Sch R.pdf	Form
2017 Schedule SB ( 2017 Schedule SB (Form 5500) - Single-Employer Defined B 170203 RLSO Sch SB.pdf	Form
Justification for NonSubstantive No Material Change Form 5500 2017.pdf Justification Non-Substantial Change	IC Document

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	2017 Form 5500	2017 Annual Return/Report of Employee Benefit Plan (Clean)	170203 Clean Form 5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Form 5500-SF	2017 Short Form Annual Return/Report of Small Employee Benefit Plan (Clean)	170203 Clean Form 5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule A (Form 5500)	2017 Schedule A (Form 5500) - Insurance Information (Clean)	170203 Clean Sch A.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule C (Form 5500)	2017 Schedule C (Form 5500) - Service Provider Information (Clean)	170203 Clean Sch C.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule D (Form 5500)	2017 Schedule D (Form 5500) - DFE/Participating Plan Information (Clean)	170203 Clean Sch D.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule G (Form 5500)	2017 Schedule G (Form 5500) - Financial Transaction Schedules (Clean)	170203 Clean Sch G.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule H (Form 5500)	2017 Schedule H (Form 5500) - Financial Information (Clean)	170203 Clean Sch H.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule I (Form 5500)	2017 Schedule I (Form 5500) - Financial Information - Small Plan (Clean)	170203 Clean Sch I.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule MB (Form 5500)	2017 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (Clean)	170203 Clean Sch MB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule R (Form 5500)	2017 Schedule R (Form 55) - Retirement Plan Information (Clean)	170203 Clean Sch MB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule SB (Form 5500)	2017 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (Clean)	170203 Clean Sch SB.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2017 Form 5500 Instructions CLEAN 032317.pdf	Yes	No	Printable Only
Instruction			2017 Form 5500SF Instruction CLEAN 032317.pdf	Yes	No	Printable Only
Form	2017 Form 5500	2017 Annual Return/Report of Employee Benefit Plan (RLSO)	170203 RLSO Form 5500.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Form 5500-SF	2017 Short Form Annual Return/Report of Small Employee Benefit Plan (RLSO)	170203 RLSO Form 5500SF.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule A (Form 5500)	2017 Schedule A (Form 5500) - Insurance Information (RLSO)	170203 RLSO Sch A.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule C (Form 5500)	2017 Schedule C (Form 5500) - Service Provider Information (RLSO)	170203 RLSO Sch C.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule D (Form 5500)	2017 Schedule D (Form 5500) - DFE/Participating Plan Information (RLSO)	170203 RLSO Sch D.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule G (Form 5500)	2017 Schedule G (Form 5500) - Financial Transaction Schedules (RLSO)	170203 RLSO Sch G.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule H (Form 5500)	2017 Schedule H (Form 5500) - Financial Information (RLSO)	170203 RLSO Sch H.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule I (Form 5500)	2017 Schedule I (Form 5500) - Financial Information - Small Plan (RLSO)	170203 RLSO Sch I.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule MB (Form 5500)	2017 Schedule MB (Form 5500) - Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information (RLSO)	170203 RLSO Sch MB.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule R (Form 5500)	2017 Schedule R (Form 55) - Retirement Plan Information (RLSO)	170203 RLSO Sch R.pdf	Yes	Yes	Fillable Fileable Signable
Form	2017 Schedule SB (Form 5500)	2017 Schedule SB (Form 5500) - Single-Employer Defined Benefit Plan Actuarial Information (RLSO)	170203 RLSO Sch SB.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2017 Form 5500 Instructions RLSO 032317.pdf	Yes	No	Printable Only
Instruction			2017 Form 5500SF Instruction RLSO 032317.pdf	Yes	No	Printable Only

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: 23,700

Number of Respondents for Small Entity: 17,300

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	23,700	-300	24,000
Annual IC Time Burden (Hours)	1,185	-15	1,200
Annual IC Cost Burden (Dollars)	1,655,000	190,000	1,465,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification Non-Substantial Change	Justification for NonSubstantive No Material Change Form 5500 2017.pdf	03/27/2017

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