Information Collection

Termination of Multiemployer Plans (29 CFR Part 4041A)

IC 13529 under ICR 201807-1212-001 · OMB 1212-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0020 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 001 Termination of Multiemployer Plans (29 CFR Part 4041A)	Form
001 Notice of Termination NOT.pdf efilingportal.pbgc.gov/site/	Form
E-Filing Portal - Paperwork Reduction Act Notice 9-5.docx PRA Notice	IC Document

IC Title:

Termination of Multiemployer Plans (29 CFR Part 4041A)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4041A (To search for a specific CFR, visit the Code of Federal Regulations.)

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	001	Notice of Termination	NOT.pdf	https://efilingportal.pbgc.gov/site/	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000	-11	1,011
Annual IC Time Burden (Hours)	69	52	17
Annual IC Cost Burden (Dollars)	50,000	46,150	3,850

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PRA Notice	E-Filing Portal - Paperwork Reduction Act Notice 9-5.docx	09/10/2018

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