Annual Information Return/Report of Employee Benefit Plan

OMB: 1210-0110

IC ID: 13467

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:

2024-04-02 - No material or nonsubstantive change to a currently approved collection
2023-12-18 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Final Round 2019 Form 5500 Instructions 032019 clean.doc Instruction
2019 Form 5500SF Instructions 031919 clean.doc Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan 190130 Form 5500 clean.docx Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi 190130 Form 5500SF clean.docx Form
Form 5500 Schedule Insurance Information 190130 Sch A clean.docx Form
Form 5500 Schedule Service Provider Information 190130 Sch C clean.docx Form
Form 5500 Schedule DFE/Participating Plan Information 190130 Sch D clean.docx Form
Form 5500 Schedule Financial Transaction Schedules 190130 Sch G clean.docx Form
Form 5500 Schedule Financial Information 190130 Sch H clean.docx Form
Form 5500 Schedule Financial Information--Small Plans 190130 Sch I clean.docx Form
Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Pu 190130 Sch MB clean.docx Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati 190130 Sch SB clean.docx Form
Form 5500 Schedule Retirement Plan Information 190130 Sch R clean.docx Form
Final Round 2019 Form 5500 Instructions 032019.doc Form 5500 Instructions (Red Line) IC Document
2019 Form 5500SF Instructions 031919.doc Form 5500-SF Instructions (Red Line) IC Document
190130 Form 5500.docx Form 5500 (Red Line) IC Document
190130 Form 5500SF.docx Form 5500-SF (Red Line) IC Document
190130 Sch A.docx Schedule A (Red Line) IC Document
190130 Sch C.docx Schedule C (Red Line) IC Document
190130 Sch D.docx Schedule D (Red Line) IC Document
190130 Sch G.docx Schedule G (Red Line) IC Document
190130 Sch H.docx Schedule H (Red Line) IC Document
190130 Sch I.docx Schedule I (Red Line) IC Document
190130 Sch MB.docx Schedule MB (Red Line) IC Document
190130 Sch SB.docx Schedule SB (Red Line) IC Document
190130 Sch R.docx Schedule R (Red Line) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Information Return/Report of Employee Benefit Plan	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2520.103-1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Final Round 2019 Form 5500 Instructions 032019 clean.doc	Yes	Yes	Fillable Fileable
Instruction			2019 Form 5500SF Instructions 031919 clean.doc	Yes	Yes	Fillable Fileable
Form	Form 5500	Annual Return/Report of Employee Benefit Plan	190130 Form 5500 clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	Short Form Annual Return/Report of Small Employee Benefit Plan	190130 Form 5500SF clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule A	Insurance Information	190130 Sch A clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule C	Service Provider Information	190130 Sch C clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule D	DFE/Participating Plan Information	190130 Sch D clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule G	Financial Transaction Schedules	190130 Sch G clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule H	Financial Information	190130 Sch H clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule I	Financial Information--Small Plans	190130 Sch I clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule MB	Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information	190130 Sch MB clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule SB	Single-Employer Defined Benefit Plan Actuarial Information	190130 Sch SB clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule R	Retirement Plan Information	190130 Sch R clean.docx	Yes	Yes	Fillable Fileable Signable

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: 804,000	Number of Respondents for Small Entity: 676,000

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	804,000	804,000
Annual IC Time Burden (Hours)	574,000	574,000
Annual IC Cost Burden (Dollars)	254,079,000	254,079,000

Documents for IC

Title	Document	Date Uploaded
Form 5500 Instructions (Red Line)	Final Round 2019 Form 5500 Instructions 032019.doc	03/21/2019
Form 5500-SF Instructions (Red Line)	2019 Form 5500SF Instructions 031919.doc	03/20/2019
Form 5500 (Red Line)	190130 Form 5500.docx	03/20/2019
Form 5500-SF (Red Line)	190130 Form 5500SF.docx	03/20/2019
Schedule A (Red Line)	190130 Sch A.docx	03/20/2019
Schedule C (Red Line)	190130 Sch C.docx	03/20/2019
Schedule D (Red Line)	190130 Sch D.docx	03/20/2019
Schedule G (Red Line)	190130 Sch G.docx	03/20/2019
Schedule H (Red Line)	190130 Sch H.docx	03/20/2019
Schedule I (Red Line)	190130 Sch I.docx	03/20/2019
Schedule MB (Red Line)	190130 Sch MB.docx	03/20/2019
Schedule SB (Red Line)	190130 Sch SB.docx	03/20/2019
Schedule R (Red Line)	190130 Sch R.docx	03/20/2019

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