Reportable Events

Reportable Events

OMB: 1212-0013

IC ID: 13522

Information Collection (IC) Details

View Information Collection (IC)

Reportable Events
 
No Modified
 
Mandatory
 
29 CFR 4043

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Form 10 Post-Event Notice of Reportable Events Form-10_Revised_Clean.docx Yes Yes Fillable Fileable Signable
Instruction Form-10-Instructions_Revised_Clean.docx Yes Yes Fillable Fileable Signable
Form Form 10-Advance Advance Notice of Reportable Events Form-10-Advance.docx Yes Yes Fillable Fileable Signable
Instruction Form-10-AdvanceInstructions_Revised_Clean.docx Yes Yes Fillable Fileable Signable
Other-Screen shots 4043 screenshots_Revised April 2021.docx Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

573 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 573 0 0 51 0 522
Annual IC Time Burden (Hours) 1,802 0 0 161 0 1,641
Annual IC Cost Burden (Dollars) 426,885 0 0 37,995 0 388,890

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

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