OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Revenue Procedure 2021-30 which includes Forms 14568, 14568-A thru I

IC 19094 under ICR 202208-1545-005 · OMB 1545-1673.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 14568
Revenue Procedure 2021-30 which includes Forms 14568, 14568-A thru I		 Form
14568 Appendix C Part I Model VCP Submission Compliance Statem
f14568--2019-11-00.pdf 		Form
14568-A Appendix C Part II Schedule 1 Interim and Certain Discre
f14568-a--2019-11-00.pdf 		Form
14568-B Appendix C Part II Schedule 2 Nonamender Failures (other
f14568-b--2018-06-00.pdf 		Form
14568-C Appendix C Part II Schedule 3 SEPs and SARSEPs
f14568-c--2017-09-00.pdf 		Form
14568-D Appendix C Part II Schedule 4 Simple IRAs
f14568-d--2017-09-00.pdf 		Form
14568-E Appendix C Part II Schedule 5 Plan Loan Failures (Qualif
f14568-e--2018-06-00.pdf 		Form
14568-F Appendix C Part II Schedule 6 Employer Eligibility Failu
f14568-f--2020-03-00.pdf 		Form
14568-G Appendix C Part II Schedule 7 Failure to Distribute Elec
f14568-g--2020-03-00 (3).pdf 		Form
14568-H Appendix C Part II Schedule 8 Failure to Pay Required Mi
f14568-h--2018-06-00.pdf 		Form
14568-I Appendix C Part II Schedule 9 Correction by Plan Amendme
f14568-i--2017-09-00.pdf 		Form
Rev Proc-2021-30 .pdf
Rev Proc 2021-30		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 14568 Appendix C Part I Model VCP Submission Compliance Statement f14568--2019-11-00.pdf Yes Yes Fillable Fileable
Form 14568-A Appendix C Part II Schedule 1 Interim and Certain Discretionary Nonamender Failures f14568-a--2019-11-00.pdf Yes Yes Fillable Fileable
Form 14568-B Appendix C Part II Schedule 2 Nonamender Failures (other than those to which Schedule 1 applies) and Failure to Adopt a 403(b) Plan Timely f14568-b--2018-06-00.pdf Yes Yes Fillable Fileable
Form 14568-C Appendix C Part II Schedule 3 SEPs and SARSEPs f14568-c--2017-09-00.pdf Yes Yes Fillable Fileable
Form 14568-D Appendix C Part II Schedule 4 Simple IRAs f14568-d--2017-09-00.pdf Yes Yes Fillable Fileable
Form 14568-E Appendix C Part II Schedule 5 Plan Loan Failures (Qualified Plans and 403(b) Plans) f14568-e--2018-06-00.pdf Yes Yes Fillable Fileable
Form 14568-F Appendix C Part II Schedule 6 Employer Eligibility Failure (§ 401(k) and 403(b) Plans only) f14568-f--2020-03-00.pdf Yes Yes Fillable Fileable
Form 14568-G Appendix C Part II Schedule 7 Failure to Distribute Elective Deferrals in Excess of the § 402(g) Limit f14568-g--2020-03-00 (3).pdf Yes Yes Fillable Fileable
Form 14568-H Appendix C Part II Schedule 8 Failure to Pay Required Minimum Distributions Timely under § 401(a)(9) f14568-h--2018-06-00.pdf Yes Yes Fillable Fileable
Form 14568-I Appendix C Part II Schedule 9 Correction by Plan Amendment (in accordance with Appendix B) f14568-i--2017-09-00.pdf Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,300 0 0 0 0 4,300
Annual IC Time Burden (Hours) 86,148 0 0 0 0 86,148
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Rev Proc 2021-30 Rev Proc-2021-30 .pdf 09/29/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.