Information Collection

Annual Information Return/Report

IC 13607 under ICR 202109-1212-002 · OMB 1212-0057.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0057 can be found here:

Documents and Forms

Document Name Document Type
2021 Form 5500 Instructions Clean (003).docx Instruction
2021 Form 5500 Instructions Clean (003).docx Instruction
2021 Form 5500SF Instructions Clean.docx Instruction
2021 Form 5500SF Instructions Clean.docx Instruction
Appendix C.docx Other-Proposed Changes To Participat
Appendix C.docx Other-Proposed Changes To Participat
Appendix E.docx Other-Other Proposed Changes to 2022
Appendix E.docx Other-Other Proposed Changes to 2022
Form 5500 2021 Form 5500 201209 Form 5500 Clean.docx Form
Form 5500 2021 Form 5500 201209 Form 5500 Clean.docx Form
Form 5500-SF 2021 Form 5500-SF 201209 Form 5500-SF Clean.docx Form
Form 5500-SF 2021 Form 5500-SF 201209 Form 5500-SF Clean.docx Form
Schedule A 2021 Schedule A 201209 Sch A Clean.docx Form
Schedule A 2021 Schedule A 201209 Sch A Clean.docx Form
Schedule C 2021 Schedule C 201209 Sch C Clean.docx Form
Schedule C 2021 Schedule C 201209 Sch C Clean.docx Form
Schedule D 2021 Schedule D 201209 Sch D Clean.docx Form
Schedule D 2021 Schedule D 201209 Sch D Clean.docx Form
Schedule G 2021 Schedule G 201209 Sch G Clean.docx Form
Schedule G 2021 Schedule G 201209 Sch G Clean.docx Form
Schedule H 2021 Schedule H 201209 Sch H Clean.docx Form
Schedule H 2021 Schedule H 201209 Sch H Clean.docx Form
Schedule I 2021 Schedule I 201209 Sch I Clean.docx Form
Schedule I 2021 Schedule I 201209 Sch I Clean.docx Form
Schedule MB 2021 Schedule MB 201209 Sch MB Clean.docx Form
Schedule MB 2021 Schedule MB 201209 Sch MB Clean.docx Form
Schedule R 2021 Schedule R 201209 Sch R Clean.docx Form
Schedule R 2021 Schedule R 201209 Sch R Clean.docx Form
Schedule SB 2021 Schedule SB 201209 Sch SB Clean.docx Form
Schedule SB 2021 Schedule SB 201209 Sch SB Clean.docx Form
Schedule DCG Proposed Schedule DCG (Individual Plan Information) and Appendix B (Proposed Schedule DCG (Individual Plan Information) and Instructions).docx Form and Instruction
Schedule DCG Proposed Schedule DCG (Individual Plan Information) and Appendix B (Proposed Schedule DCG (Individual Plan Information) and Instructions).docx Form and Instruction
Schedule MEP Proposed Schedule MEP (Multiple-Employer Retirement Plan Appendix A (Proposed Schedule MEP (Multiple-Employer Retirement Plan Information) and Instructions).docx Form and Instruction
Schedule MEP Proposed Schedule MEP (Multiple-Employer Retirement Plan Appendix A (Proposed Schedule MEP (Multiple-Employer Retirement Plan Information) and Instructions).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Information Return/Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4065

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2021 Form 5500 Instructions Clean (003).docx	Yes	Yes	Fillable Fileable
Instruction			2021 Form 5500SF Instructions Clean.docx	Yes	Yes	Fillable Fileable
Form	Form 5500	2021 Form 5500	201209 Form 5500 Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	2021 Form 5500-SF	201209 Form 5500-SF Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Schedule A	2021 Schedule A	201209 Sch A Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule C	2021 Schedule C	201209 Sch C Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule D	2021 Schedule D	201209 Sch D Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule G	2021 Schedule G	201209 Sch G Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule H	2021 Schedule H	201209 Sch H Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule I	2021 Schedule I	201209 Sch I Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule MB	2021 Schedule MB	201209 Sch MB Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Schedule R	2021 Schedule R	201209 Sch R Clean.docx	Yes	Yes	Fillable Fileable
Form	Schedule SB	2021 Schedule SB	201209 Sch SB Clean.docx	Yes	Yes	Fillable Fileable Signable
Form and Instruction	Schedule DCG	Proposed Schedule DCG (Individual Plan Information) and Instructions	Appendix B (Proposed Schedule DCG (Individual Plan Information) and Instructions).docx	Yes	Yes	Fillable Fileable
Form and Instruction	Schedule MEP	Proposed Schedule MEP (Multiple-Employer Retirement Plan Information) and Instructions	Appendix A (Proposed Schedule MEP (Multiple-Employer Retirement Plan Information) and Instructions).docx	Yes	Yes	Fillable Fileable
Other-Proposed Changes To Participating Employer Information under ERISA 103(G) to 2021 Form 5500/Form 5500-SF Instructions			Appendix C.docx	Yes	Yes	Fillable Fileable
Other-Other Proposed Changes to 2022 Form 5500, Form 5500-SF, Form 5500-EZ, Schedules and InstructionsNS			Appendix E.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,600	Number of Respondents for Small Entity: 17,300

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	24,600	0	24,600
Annual IC Time Burden (Hours)	1,242	9	1,233
Annual IC Cost Burden (Dollars)	1,647,087	0	1,647,087

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.