Information Collection Request

Special Financial Assistance by PBGC

ICR 202309-1212-001 · OMB 1212-0074 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form SFA Lock-In Applic SFA Lock-In Application Form and Instruction Unchanged Available
Form SFA Lock-In Applic Lock-In Application Form and Instruction Unchanged Repair queued
Form SFA Filing Instruc SFA Filing Instructions, Addendum B Form and Instruction Unchanged Available
Form SFA Filing Instruc Notice of reinstatement Form and Instruction Unchanged Repair queued
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Available
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Repair queued
Form SFA Application Am SFA Application Amendment Cover Letter Form and Instruction Modified Available
Form SFA 210 SFA Template 10 Form and Instruction Modified Available
Form SFA 100 SFA Application Checklist Form and Instruction Modified Available
Form SFA 203 SFA Template 3 Form and Instruction Modified Available
Form SFA 204-A SFA Template 4A Form and Instruction Modified Available
Form Model Certificatio Model Certification Form and Instruction Modified Available
Form Model Plan Amendme Model Plan Amendment, Reinstatement Form and Instruction Modified Repair queued
Form Model Plan Amendme Model Plan Amendment, Compliance Form and Instruction Modified Repair queued
Form SFA 206-B SFA Template 6B Form and Instruction Modified Available
Form SFA 205-B SFA Template 5B Form and Instruction Modified Available
Form PBGC E-filing Port PBGC E-filing Portal Form Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum D Form and Instruction Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum C Form and Instruction Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum A Form and Instruction Modified Available
Form SFA 100-Supplement SFA Template Checklist, Supplemented Application Form and Instruction Modified Available
Form SFA 209 SFA Template 9 Form and Instruction Modified Repair queued
Form SFA 208 SFA Template 8 Form and Instruction Modified Repair queued
Form SFA 207 SFA Template 7 Form and Instruction Modified Available
Form SFA 206-A SFA Template 6A Form and Instruction Modified Available
Form SFA 205-A SFA Template 5A Form and Instruction Modified Available
Form SFA 204-B SFA Template 4B Form and Instruction Modified Available
Form SFA 202 SFA Template 2 Form and Instruction Modified Repair queued
Form SFA 201 SFA Template 1 Form and Instruction Modified Available
Form SFA 201 Application for Special Financial Assistance Form and Instruction Modified Repair queued
Justification Nonmaterial Change TOP and LeapFile.04.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-09-25 Repair queued
Special Financial Assistance ICR (July 2023 Renewal) Supporting Statement.12.docx Supporting Statement A Uploaded 2023-07-17 Repair queued
sfa-assumptions-guidance July 2023.03.pdf Supplementary Document Uploaded 2023-06-02 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
254199 Lock-In Application Form and Instruction UnchangedSFA Lock-In Application
254199 Lock-In Application Form and Instruction Unchanged
247988 Requests for determination Unchanged
247977 Notice of reinstatement Form and Instruction UnchangedSFA Filing Instructions, Addendum B
247977 Notice of reinstatement Form and Instruction Unchanged
247976 Annual Statement of Compliance Form and Instruction UnchangedAnnual Statement of Compliance
247976 Annual Statement of Compliance Form and Instruction Unchanged
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Application Amendment Cover Letter
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 10
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Application Checklist
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 3
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 4A
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Certification
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Plan Amendment, Reinstatement
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Plan Amendment, Compliance
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 6B
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 5B
247975 Application for Special Financial Assistance Form ModifiedPBGC E-filing Portal
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum D
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum C
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template Checklist, Supplemented Application
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 9
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 8
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 7
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 6A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 5A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 4B
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 2
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 1
247975 Application for Special Financial Assistance Form and Instruction Modified
247975 Application for Special Financial Assistance Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2026 07/31/2026 07/31/2026
210 0 210
938 0 938
2,248,400 0 2,248,400





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Annual Statement of Compliance SFA 300
Application for Special Financial Assistance SFA Application Amendment Cover Letter, SFA Filing Instructions, Addendum A, SFA 202, SFA 201, SFA 204-B, SFA 205-A, SFA 206-A, SFA 100-Supplemented , SFA 207, SFA 208, SFA 209, SFA Filing Instructions, Addendum C, SFA Filing Instructions, Addendum D, PBGC E-filing Portal, SFA 204-A, SFA 205-B, SFA 206-B, Model Plan Amendment, Compliance, Model Plan Amendment, Reinstatement, Model Certification, SFA 203, SFA 100, SFA 210 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Lock-In Application SFA Lock-In Application
Notice of reinstatement SFA Filing Instructions, Addendum B
Requests for determination

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 210 210 0 0 0 0
Annual Time Burden (Hours) 938 938 0 0 0 0
Annual Cost Burden (Dollars) 2,248,400 2,248,400 0 0 0 0


Reginfo record details
  No