Annual Return/Report of Employee Benefit Plan

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Sch SB (Form 5500) Single-Employer Defined Benefit Plan Actuarial Information	Form	Modified	Available
Form Sch R (Form 5500) Retirement Plan Information	Form	Modified	Available
Form Sch MB (Form 5500) Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information	Form	Modified	Available
Form Sch I (Form 5500) Financial Information—Small Plan	Form	Modified	Available
Form Sch H (Form 5500) Financial Information	Form	Modified	Available
Form Sch G (Form 5500) Financial Transaction Schedules	Form	Modified	Available
Form Sch D (Form 5500) DFE/Participating Plan Information	Form	Modified	Available
Form Sch C (Form 5500) Service Provider Information	Form	Modified	Available
Form Sch A (Form 5500) Insurance Information	Form	Modified	Available
Form 5500SF Short Form Annual Return/Report of Small Employee Benefit Plan	Form	Modified	Available
Form 5500 Annual Return/Report of Employee Benefit Plan	Form	Modified	Available
Form 5500-SUP Annual Return of Employee Benefit Plan Supplemental Information	Form	Unchanged	Available
Justification of non material change v2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-03-29	Available
IRS 2007-2011, 2013-2018.pdf	Supplementary Document	Uploaded 2018-03-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Single-Employer Defined Benefit Plan Actuarial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Retirement Plan Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information—Small Plan
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Financial Transaction Schedules
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	DFE/Participating Plan Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Service Provider Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Insurance Information
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Short Form Annual Return/Report of Small Employee Benefit Plan
40957	Annual Return/Report of Employee Benefit Plan	Form	Modified	Annual Return/Report of Employee Benefit Plan
40957	Annual Return/Report of Employee Benefit Plan	Instruction	Modified
215776	Form 5500-SUP - Annual Return of Employee Benefit Plan Supplemental Information	Form	Unchanged	Annual Return of Employee Benefit Plan Supplemental Information
215776	Form 5500-SUP - Annual Return of Employee Benefit Plan Supplemental Information	Instruction	Unchanged

ICR Details

OMB Control No: 1545-1610	ICR Reference No: 201803-1545-013
Status: Historical Active	Previous ICR Reference No: 201703-1545-012
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Annual Return/Report of Employee Benefit Plan
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/02/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/29/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2019	10/31/2019	10/31/2019
Responses	833,500	0	828,500
Time Burden (Hours)	339,208	0	338,208
Cost Burden (Dollars)	132,661,000	0	137,129,000

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Abstract: Form 5500 is an annual information return filed by employee benefit plans. The IRS uses this information to determine if the plan appears to be operating properly as required under the law or whether the plan should be audited.

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Authorizing Statute(s): PL: Pub.L. 109 - 280 1 Name of Law: The Pension Protection Act of 2006 (PPA)
   US Code: 26 USC 6058 Name of Law: Information required in connection with certain plans of deferred compensation
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 192 430 Name of Law: Pension Relief Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 18687	03/31/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 42794	06/30/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Annual Return/Report of Employee Benefit Plan	5500, Sch C (Form 5500), Sch A (Form 5500), Sch D (Form 5500), Sch R (Form 5500), Sch SB (Form 5500) , 5500SF, Sch G (Form 5500), Sch H (Form 5500), Sch I (Form 5500), Sch MB (Form 5500)	Annual Return/Report of Employee Benefit Plan ,   Short Form Annual Return/Report of Small Employee Benefit Plan ,   Insurance Information ,   Service Provider Information ,   DFE/Participating Plan Information ,   Financial Transaction Schedules ,   Financial Information ,   Financial Information—Small Plan ,   Multiemployer Defined Benefit Plan and Certain Money Purchase Plan Actuarial Information ,   Retirement Plan Information ,   Single-Employer Defined Benefit Plan Actuarial Information
Form 5500-SUP - Annual Return of Employee Benefit Plan Supplemental Information	5500-SUP	Annual Return of Employee Benefit Plan Supplemental Information

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	833,500	828,500	0	0	5,000	0
Annual Time Burden (Hours)	339,208	338,208	0	0	1,000	0
Annual Cost Burden (Dollars)	132,661,000	137,129,000	0	0	-4,468,000	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Form 5500 is a Tri-Agency form shared between Department of Labor OMB Control Number 1210-0110, Pension Benefit Guaranty Corporation (PBGC) OMB Control Number 1212-0057 and Internal Revenue Service OMB Control Number 1545-1610. Since this is a Tri-Agency form, the three agencies coordinate the information collection submissions by March 30, 2018 to OMB in order to maximize the information available to OMB. Lines 42 and 43 of the Schedule SB will not be used for plan years beginning on or after January 1, 2018, because there are no installment acceleration amounts or installment acceleration amount carryovers after 2017. Therefore, IRS is removing Lines 42 and 43 from the Form 5500 Series Schedule SB. • IRS is revising the estimates such that for the “Annual Return/Report” IC (See accompanying document for greater detail): o Responses increased from 828,000 to 833,000 (+5,000) due to additional filings o Burden hours increased from 338,000 to 339,000 (+1,000) led by the filing increase o Labor costs decreased from $137.129 million to $132.661 million (-$4.468 million) Decreased wage rates (due to an adjustment in how the Department of Labor calculates the overhead cost input for wage rates) led the cost burden to decrease.

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Annual Cost to Federal Government: $5,250,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/29/2018

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