Annual Information Return/Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Schedule SB 2022 Schedule SB	Form	Modified	Available
Form Schedule R 2022 Schedule R	Form	Modified	Available
Form Schedule MB 2022 Schedule MB	Form	Modified	Available
Form Schedule I 2022 Schedule I	Form	Modified	Available
Form Schedule H 2022 Schedule H	Form	Modified	Available
Form Schedule G 2022 Schedule G	Form	Modified	Available
Form Schedule D 2022 Schedule D	Form	Modified	Available
Form Schedule C 2022 Schedule C	Form	Modified	Available
Form Schedule A 2022 Schedule A	Form	Modified	Available
Form Form 5500-SF 2022 Form 5500-SF	Form	Modified	Available
Form Form 5500 2022 Form 5500	Form	Modified	Repair queued
2022 PBGC Supporting Statement final 5.2022 - v.2.docx	Supporting Statement A	Uploaded 2022-05-20	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13607	Annual Information Return/Report	Form	Modified	2022 Schedule SB
13607	Annual Information Return/Report	Form	Modified	2022 Schedule R
13607	Annual Information Return/Report	Form	Modified	2022 Schedule MB
13607	Annual Information Return/Report	Form	Modified	2022 Schedule I
13607	Annual Information Return/Report	Form	Modified	2022 Schedule H
13607	Annual Information Return/Report	Form	Modified	2022 Schedule G
13607	Annual Information Return/Report	Form	Modified	2022 Schedule D
13607	Annual Information Return/Report	Form	Modified	2022 Schedule C
13607	Annual Information Return/Report	Form	Modified	2022 Schedule A
13607	Annual Information Return/Report	Form	Modified	2022 Form 5500-SF
13607	Annual Information Return/Report	Form	Modified	2022 Form 5500
13607	Annual Information Return/Report	Instruction	Modified

ICR Details

OMB Control No: 1212-0057	ICR Reference No: 202205-1212-005
Status: Historical Active	Previous ICR Reference No: 202103-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Annual Information Return/Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/21/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/23/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2025	36 Months From Approved	02/28/2023
Responses	25,000	0	24,600
Time Burden (Hours)	17,743	0	1,233
Cost Burden (Dollars)	0	0	1,647,087

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Abstract: Sections 104 and 4065 of ERISA require plan administrators to file an annual report. The report must contain the information described in section 103 of ERISA. The Form 5500 Series provides a standard format for fulfilling that requirement.

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Authorizing Statute(s): US Code: 29 USC 1302(b)(3), 1365 Name of Law: ERISA
  

Citations for New Statutory Requirements: Statute at Large: 120 Stat. 780 Name of Statute: Pension Protection Act of 2006

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB97	Final or interim final rulemaking	87 FR 3113	05/23/2022

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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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	Form 5500, Form 5500-SF, Schedule A, Schedule C, Schedule D, Schedule G, Schedule H, Schedule I, Schedule R, Schedule MB, Schedule SB	2022 Form 5500 ,   2022 Form 5500-SF ,   2022 Schedule A ,   2022 Schedule C ,   2022 Schedule D ,   2022 Schedule G ,   2022 Schedule H ,   2022 Schedule I ,   2022 Schedule MB ,   2022 Schedule R ,   2022 Schedule SB

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	25,000	24,600	0	0	400	0
Annual Time Burden (Hours)	17,743	1,233	0	0	16,510	0
Annual Cost Burden (Dollars)	0	1,647,087	0	0	-1,647,087	0

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: PBGC estimates an increase of 16,501 hours in the hour burden from 1,242 to 17,743. PBGC estimates that the increase is due to the Agencies incorporation of OMB’s guidance that the burden incurred by service providers should be reported as an hour burden in item 12 of the Supporting Statement instead of as a cost burden in item 13 of the Supporting Statement. Therefore, PBGC is no longer including those service provider hours as cost burden in item 13 of the Supporting Statement.

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Annual Cost to Federal Government: $967,000

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: 05/23/2022

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