Form T and instructions

Termination Premium

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0064 can be found here:

Documents and Forms

Document Name Document Type
Form Form T Form T and instructions Form and Instruction
Form T Form T form-t-package rev.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Form T and instructions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4000, 4007 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form T	Form T	form-t-package rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3	0	3
Annual IC Time Burden (Hours)	1	1	0
Annual IC Cost Burden (Dollars)	200	0	200

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.