Information Collection

Payment of Premiums (29 CFR part 4007)

IC 13518 under ICR 202112-1212-005 · OMB 1212-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0009 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Premium Filing Payment of Premiums (29 CFR part 4007)	Form
2022 CPF Instructions - Dec 13.docx	Instruction
2022 CPF Instructions - Dec 13.docx	Instruction
Premium Filing Premium Filing Screen Shots My PAA Data Entry Screens 2021.pdf	Form
Premium Filing Premium Filing Screen Shots My PAA Data Entry Screens 2021.pdf	Form

IC Title:

Payment of Premiums (29 CFR part 4007)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4007

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
Form	Premium Filing	Premium Filing Screen Shots	My PAA Data Entry Screens 2021.pdf		Yes	Yes	Fillable Fileable Signable
Instruction			2022 CPF Instructions - Dec 13.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31,245

Number of Respondents for Small Entity: 17,060

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	31,245	31,245
Annual IC Time Burden (Hours)	13,540	13,540
Annual IC Cost Burden (Dollars)	21,621,540	21,621,540

Documents for IC

table that charts IC Documents
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.