Information Collection

Notices Following a Substantial Cessation of Operations

IC 237358 under ICR 202207-1212-004 · OMB 1212-0073.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0073 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
form-4062-e-instructions 2022.pdf www.pbgc.gov/sites/default/files/form-4062-e-instructions.pdf	Instruction
form-4062-e-instructions 2022.pdf www.pbgc.gov/sites/default/files/form-4062-e-instructions.pdf	Instruction
PBGC Form 4062(e)- Notice of Section 4062(e) Event notice-section-4062e4-event-form 2022.pdf www.pbgc.gov/sites/default/files/notice-section-4062e4-event-form.pdf	Form
PBGC Form 4062(e)- Notice of Section 4062(e) Event notice-section-4062e4-event-form 2022.pdf www.pbgc.gov/sites/default/files/notice-section-4062e4-event-form.pdf	Form
PBGC Form 4062(e)- Notice of Election under ERISA 4062(e)(4) notice-elect-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-elect-erisa-4062e4-form.pdf	Form
PBGC Form 4062(e)- Notice of Election under ERISA 4062(e)(4) notice-elect-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-elect-erisa-4062e4-form.pdf	Form
PBGC Form 4062(e)- Notice of Additional Contributions under ERISA 4062(e)(4 notice-addt-contrib-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-addt-contrib-erisa-4062e4-form.pdf	Form
PBGC Form 4062(e)- Notice of Additional Contributions under ERISA 4062(e)(4 notice-addt-contrib-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-addt-contrib-erisa-4062e4-form.pdf	Form
PBGC Form 4062(e)- Notice of Failure to Make Additional Contributions under notice-fail-addt-contrib-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-fail-addt-contrib-erisa-4062e4-form.pdf	Form
PBGC Form 4062(e)- Notice of Failure to Make Additional Contributions under notice-fail-addt-contrib-erisa-4062e4-form 2022.pdf www.pbgc.gov/sites/default/files/notice-fail-addt-contrib-erisa-4062e4-form.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Notices Following a Substantial Cessation of Operations

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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
Instruction			form-4062-e-instructions 2022.pdf	https://www.pbgc.gov/sites/default/files/form-4062-e-instructions.pdf	Yes	Yes	Fillable Fileable
Form	PBGC Form 4062(e)-01	Notice of Section 4062(e) Event	notice-section-4062e4-event-form 2022.pdf	https://www.pbgc.gov/sites/default/files/notice-section-4062e4-event-form.pdf	Yes	Yes	Fillable Fileable
Form	PBGC Form 4062(e)-02	Notice of Election under ERISA 4062(e)(4)	notice-elect-erisa-4062e4-form 2022.pdf	https://www.pbgc.gov/sites/default/files/notice-elect-erisa-4062e4-form.pdf	Yes	Yes	Fillable Fileable
Form	PBGC Form 4062(e)-03	Notice of Additional Contributions under ERISA 4062(e)(4)	notice-addt-contrib-erisa-4062e4-form 2022.pdf	https://www.pbgc.gov/sites/default/files/notice-addt-contrib-erisa-4062e4-form.pdf	Yes	Yes	Fillable Fileable
Form	PBGC Form 4062(e)-04	Notice of Failure to Make Additional Contributions under ERISA 4062(e)(4)	notice-fail-addt-contrib-erisa-4062e4-form 2022.pdf	https://www.pbgc.gov/sites/default/files/notice-fail-addt-contrib-erisa-4062e4-form.pdf	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: 5

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5	-65	70
Annual IC Time Burden (Hours)	39	-276	315
Annual IC Cost Burden (Dollars)	39,415	-53,335	92,750

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.