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Termination of Single Employer Plans
Termination of Single Employer Plans
OMB: 1212-0036
IC ID: 13567
OMB.report
PBGC
OMB 1212-0036
ICR 201911-1212-004
IC 13567
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0036 can be found here:
2024-09-25 - No material or nonsubstantive change to a currently approved collection
2023-10-20 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Clean Distress filing instructions March 2018.pdf
Instruction
Final Std. Termination Instructions to OMB.pdf
Instruction
Final - schedule-mp-instructions to OMB.pdf
Instruction
PBGC Form 501 Post-Distribution Certification for Standard Termination
Clean Standard Termination Form 501 March 2018.pdf
Form
PBGC Form 500 Standard Termination Notice Single-Employer Plan Termina
Form 500.pdf
Form
Schedule MP (to fo Missing Participant Information
Clean Schedule MP forms March 2018.pdf
Form
PBGC Form 600, 601 Distress Termination - Notice to PBGC of Intent to Termi
Clean Distress Termination forms March 2018.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Termination of Single Employer Plans
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 4050
29 CFR 4041
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Clean Distress filing instructions March 2018.pdf
Yes
No
Paper Only
Form
PBGC Form 501
Post-Distribution Certification for Standard Termination
Clean Standard Termination Form 501 March 2018.pdf
Yes
Yes
Fillable Printable
Form
PBGC Form 500
Standard Termination Notice Single-Employer Plan Termination
Form 500.pdf
Yes
Yes
Fillable Printable
Form
Schedule MP (to forms 501 and 602)
Missing Participant Information
Clean Schedule MP forms March 2018.pdf
Yes
Yes
Fillable Printable
Form
PBGC Form 600, 601, 602
Distress Termination - Notice to PBGC of Intent to Terminate; Distress Termination - Single-Employer Plan; Post-Distribution Certification for Distress Termination
Clean Distress Termination forms March 2018.pdf
Yes
Yes
Fillable Printable
Instruction
Final Std. Termination Instructions to OMB.pdf
Yes
Yes
Fillable Printable
Instruction
Final - schedule-mp-instructions to OMB.pdf
Yes
Yes
Fillable Printable
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:
1,513
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
1,513
0
87
0
0
1,426
Annual IC Time Burden (Hours)
30,941
0
1,051
0
0
29,890
Annual IC Cost Burden (Dollars)
6,178,200
0
214,800
0
0
5,963,400
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.