Information Collection

Registration Requirements to Serve as a Pooled Plan Provider to Pooled Employer Plans

IC 241148 under ICR 202308-1210-002 · OMB 1210-0164.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0164 can be found here:

Documents and Forms

Document Name Document Type
Form Form PR Registration Requirements to Serve as a Pooled Plan Provider to Pooled Employer Plans Form and Instruction
Form PR Registration Requirement to Serve as Pooled Plan Provide FormPRtoOMB.pdf Form and Instruction
Form PR Registration Requirement to Serve as Pooled Plan Provide FormPRtoOMB.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Registration Requirements to Serve as a Pooled Plan Provider to Pooled Employer Plans	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2510.3-44

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form PR	Registration Requirement to Serve as Pooled Plan Provider of Pooled Employer Plan	FormPRtoOMB.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 930	Number of Respondents for Small Entity: 809

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	930	-1,883	2,813
Annual IC Time Burden (Hours)	465	-1,211	1,676
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.