Information Collection Request
Annual Information Return/Report of Employee Benefit Plan
ICR 202212-1210-003 · OMB 1210-0110 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1210-0110 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form Form 5500 Annual Information Return/Report of Employee Benefit Plan |
Form | Modified | Repair queued |
 1210-0110 SS FINAL 2023 5500 01.12.2023.docx |
Supporting Statement A | Uploaded 2023-01-12 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13467 |  Annual Information Return/Report of Employee Benefit Plan |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0110 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202203-1210-005 |
| Agency Tracking No | 1210-0110 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |