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Settlement Agreements Between a Plan and Party in Interest
Settlement Agreements Between a Plan and a Party in Interest
OMB: 1210-0091
IC ID: 13416
OMB.report
DOL/EBSA
OMB 1210-0091
ICR 201810-1210-004
IC 13416
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0091 can be found here:
2022-02-24 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
PTE 94-71.doc
Other-PTE 94-71
pte 2003-39.pdf
Other-PTE 2003-39
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Settlement Agreements Between a Plan and Party in Interest
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-PTE 2003-39
pte 2003-39.pdf
Yes
No
Printable Only
Other-PTE 94-71
PTE 94-71.doc
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:
4
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
54 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,080
0
0
-540
0
1,620
Annual IC Time Burden (Hours)
23
0
0
-19
0
42
Annual IC Cost Burden (Dollars)
275
0
0
-267
0
542
Documents for IC
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.