Sample Cover Email for Withdrawal Liability Survey

Sample cover email withdrawal liability survey.docx

Survey of Multiemployer Pension Plan Withdrawal Liability Information

Sample Cover Email for Withdrawal Liability Survey

OMB: 1212-0071

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Withdrawal liability survey sample email message.


PBGC’s Multiemployer Program Division will distribute the survey via email.



Plan administrator / Plan attorney,


Attached is a withdrawal liability survey to be completed by all insolvent and/or terminated multiemployer plans with more than 500 participants of which the XXXXXXXX Plan is one. Please review the survey and the attached Paperwork Reduction Act Notice, which provides important information about the survey. We ask that you return the completed survey to us via email within 60 days. Note that sample data is pre-populated in the first 4 rows for illustrative purposes only and should be deleted. If only partial information is available for a particular employer, please fill out the survey to the best of your ability and write in “unknown” for data that isn’t available. If you have any questions, or need further clarification, please let us know by responding to this email with your question(s) or requesting a call.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorDuke Hilary
File Modified0000-00-00
File Created2021-10-25

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