Reportable Events

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 10 Reportable Events	Form	Modified	Repair queued
Justification Nonmaterial Change Reportable Events LeapFile.02.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-10-20	Repair queued
10&10AdvanceSptgStmt.d2.docx	Supporting Statement A	Uploaded 2021-06-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13522	Reportable Events	Form	Modified

ICR Details

OMB Control No: 1212-0013	ICR Reference No: 202310-1212-003
Status: Received in OIRA	Previous ICR Reference No: 202106-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Reportable Events
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/20/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	07/31/2024	07/31/2024
Responses	573	573
Time Burden (Hours)	1,802	1,802
Cost Burden (Dollars)	426,885	426,885

---

Abstract: Under PBGC regulations implementing 29 CFR Part 4043 of ERISA, plan administrators and contributing sponsors must notify PBGC of certain reportable events. The reporting requirements give PBGC timely notice of events that indicate plan or contributing sponsor financial problems. PBGC uses the information provided in determining what, if any, action it needs to take.

---

Authorizing Statute(s): US Code: 29 USC 1343 Name of Law: ERISA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 59660	11/05/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 31540	06/14/2021
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Reportable Events	Form 10-Advance, Form 10	Post-Event Notice of Reportable Events ,   Advance Notice of Reportable Events

---

ICR Summary of Burden

table that charts list of burden

	Total Request	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	573	573	0	0	0	0
Annual Time Burden (Hours)	1,802	1,802	0	0	0	0
Annual Cost Burden (Dollars)	426,885	426,885	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/20/2023

---