Information Collection

Wage Reports and Pension Information

IC 9470 under ICR 202203-0960-009 · OMB 0960-0547.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
sample correspondence wage rpts and pension.pdf	Other-Sample Correspondence Request
Sample ERISA Notices.docx	Other-Sample ERISA Notice

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 422.122(b)

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
Other-Sample Correspondence Request			sample correspondence wage rpts and pension.pdf		No		Paper Only
Other-Sample ERISA Notice			Sample ERISA Notices.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 580

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	580	0	580
Annual IC Time Burden (Hours)	474	184	290
Annual IC Cost Burden (Dollars)	0	0	0

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.