Information Collection Request

Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

ICR 201911-1212-003 · OMB 1212-0049 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Appendix 1 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form Modified Available
FinalRule4010supportingstatement to OMB.docx Supporting Statement A Uploaded 2020-02-04 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13583 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved 05/31/2022
560 0 560
515 0 532
12,863,858 0 12,871,040





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1
table that charts list of burden
IC Title Form No. Form Name
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Appendix 1 Appendix 1 - 4010 Illustrative form

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 560 560 0 0 0 0
Annual Time Burden (Hours) 515 532 0 -17 0 0
Annual Cost Burden (Dollars) 12,863,858 12,871,040 0 -7,182 0 0


Reginfo record details
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