Information Collection

Consent To Receive Employee Benefit Plan Disclosures Electronically

IC 13499 under ICR 202003-1210-002 · OMB 1210-0121.

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Information Collection (IC) Details

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IC Title:	Consent To Receive Employee Benefit Plan Disclosures Electronically	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 2520.104b-1(c)(2)(ii)(A)-(C) 29 CFR 2520.104-b-1(c)(1)(iii)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 757,635	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 84 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	82,853,832	78,061,088	4,792,744
Annual IC Time Burden (Hours)	1,567,541	1,547,832	19,709
Annual IC Cost Burden (Dollars)	21,441,854	21,202,217	239,637

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