Information Collection

Abandoned Individual Account Plan Termination

IC 13509 under ICR 201810-1210-003 · OMB 1210-0127.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0127 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form A Notice of Intent to Terminate Abandoned Individual Account Plan Termination	Form
Form B Notification of Plan Abandonment and Intent to Serve as Qualified Termination Administrator Abandoned Individual Account Plan Termination	Form
Form C Notice of Plan Termination Abandoned Individual Account Plan Termination	Form
Form D Final Notice Abandoned Individual Account Plan Termination	Form
Form 404a-3 Notice of Plan Termination Abandoned Individual Account Plan Termination	Form
PTE 2006-06(Pub. 2006-04-21).pdf www.gpo.gov/fdsys/pkg/FR-2006-04-21/pdf/06-3815.pdf	Instruction
PTE 2006-06 Amendment 1(Pub. 2008-10-07).pdf www.gpo.gov/fdsys/pkg/FR-2008-10-07/pdf/E8-23429.pdf	Instruction
A Notice of Intent to Terminate model-notice A-to-plan-sponsor-of-intent-to-terminate-plan-by-qta.doc	Form
B Notification of Plan Abandonment and Intent to Serve as model-notification B-of-plan-abandonment-and-intent-to-serve-as-qta.doc	Form
C Notice of Plan Termination model-notice C-of-plan-termination-to-participants-by-qta.doc	Form
D Final Notice model-final-notice D -of-plan-termination-to-ebsa-by-qta.doc	Form
404a-3 Notice of Plan Termination Model Participant Notice 2550 404a-3.docx	Form

IC Title:

Abandoned Individual Account Plan Termination

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 2550.404a-3 29 CFR 2578.1 29 CFR 2520.103-11

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		http://www.gpo.gov/fdsys/pkg/FR-2006-04-21/pdf/06-3815.pdf	Yes	No	Printable Only
Instruction		http://www.gpo.gov/fdsys/pkg/FR-2008-10-07/pdf/E8-23429.pdf	Yes	No	Printable Only
Form	A		Yes	Yes	Printable Only
Form	B		Yes	Yes	Printable Only
Form	C		Yes	Yes	Printable Only
Form	D		Yes	Yes	Printable Only
Form	404a-3		Yes	Yes	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25,105

Number of Respondents for Small Entity: 24,603

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 54 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,014,463	-293,537	1,308,000
Annual IC Time Burden (Hours)	37,680	-10,020	47,700
Annual IC Cost Burden (Dollars)	562,225	-126,775	689,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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