Information Collection

Annual compliance statement

IC 247976 under ICR 202106-1212-004 · OMB 1212-0074.

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IC Title:

Annual compliance statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4262

Information Collection Instruments:

table that charts list of 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: PBGC â 19: Office of General Counsel Case Management System

FR Citation: 83 FR 6247

Number of Respondents: 49

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	49	49
Annual IC Time Burden (Hours)	98	98
Annual IC Cost Burden (Dollars)	117,600	117,600

Documents for IC

table that charts IC Documents
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.