Information Collection

Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests

IC 17106 under ICR 201705-1545-047 · OMB 1545-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5300 Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests	Form
i5300--2017-01-00.pdf	Instruction
5300 Application for Determination for Employee Benefit Plan f5300--2017-01-00.pdf	Form

IC Title:

Form 5300, Application for Determination for Employee Benefit Plan, Schedule Q (Form 5300), Elective Determination Requests

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Form	5300	Application for Determination for Employee Benefit Plan	f5300--2017-01-00.pdf		Yes	Yes	Fillable Fileable
Instruction			i5300--2017-01-00.pdf		Yes	Yes	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 85,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	85,000	85,000
Annual IC Time Burden (Hours)	7,201,200	7,201,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.