Annual Information Return/Report of Employee Benefit Plan- SECURE Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 5500 Schedule Multiple-Employer Retirement Plan Information	Form	New	Available
Form Form 5500 Schedule Individual Plan Information	Form	New	Available
Form Form 5500 Schedule Retirement Plan Information	Form	New	Available
Form Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Information	Form	New	Available
Form Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information	Form	New	Available
Form Form 5500 Schedule Financial Information--Small Plans	Form	New	Available
Form Form 5500 Schedule Financial Information	Form	New	Available
Form Form 5500 Schedule Financial Transaction Schedules	Form	New	Available
Form Form 5500 Schedule DFE/Participating Plan Information	Form	New	Available
Form Form 5500 Schedule Service Provider Information	Form	New	Available
Form Form 5500 Schedule Insurance Information	Form	New	Available
Form Form 5500-SF Short Form Annual Return/Report of Small Employee Benefit Plan	Form	New	Available
Form Form 5500 Annual Return/Report of Employee Benefit Plan	Form	New	Available
Form 5500 1210-0NEW ss 9-15-21.docx	Supporting Statement A	Uploaded 2021-09-15	Available
2022 5500 Technical Appendix 08232021.docx	Supplementary Document	Uploaded 2021-09-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Multiple-Employer Retirement Plan Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Individual Plan Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Retirement Plan Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Single-Employer Defined Benefit Plan Actuarial Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Financial Information--Small Plans
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Financial Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Financial Transaction Schedules
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	DFE/Participating Plan Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Service Provider Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Insurance Information
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Short Form Annual Return/Report of Small Employee Benefit Plan
249003	Annual Information Return/Report of Employee Benefit Plan	Form	New	Annual Return/Report of Employee Benefit Plan
249003	Annual Information Return/Report of Employee Benefit Plan	Instruction	New

ICR Details

OMB Control No: 1210-0170	ICR Reference No: 202108-1210-014
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Annual Information Return/Report of Employee Benefit Plan- SECURE Act
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule	Conclusion Date: 11/17/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/15/2021
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Section 101 and 104 of Title I of ERISA require plan administrators to file an annual report containing the information described in section 103 of ERISA. The Form 5500 provides a standard format for fulfilling that requirement.

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Authorizing Statute(s): US Code: 29 USC 1023 Name of Law: Employee Retirement Income Security Act of 1974
  

Citations for New Statutory Requirements: PL: Pub.L. 116 - 94 O Name of Law: SECURE Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB97	Proposed rulemaking	86 FR 51488	09/15/2021

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Annual Information Return/Report of Employee Benefit Plan	Form 5500 Schedule MB, Form 5500 Schedule SB, Form 5500 Schedule DCG, Form 5500 Schedule I, Form 5500-SF, Form 5500, Form 5500 Schedule A, Form 5500 Schedule C, Form 5500 Schedule R, Form 5500 Schedule MEP, Form 5500 Schedule D, Form 5500 Schedule G, Form 5500 Schedule H	Annual Return/Report of Employee Benefit Plan ,   Short Form Annual Return/Report of Small Employee Benefit Plan ,   Insurance Information ,   Service Provider Information ,   DFE/Participating Plan Information ,   Financial Transaction Schedules ,   Financial Information ,   Financial Information--Small Plans ,   Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information ,   Single-Employer Defined Benefit Plan Actuarial Information ,   Retirement Plan Information ,   Individual Plan Information ,   Multiple-Employer Retirement Plan Information

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/15/2021

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