Information Collection Request
Pension Benefit Statement
ICR 202404-1210-001 · OMB 1210-0166 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1210-0166 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 1210-0166 Pension Benefit Statement SS 07.12.2024 clean.docx |
Supporting Statement A | Uploaded 2024-07-12 | Available |
 29 CFR 2520.pdf |
Supplementary Document | Uploaded 2020-09-21 | Repair queued |
| 29 USC 1104.pdf |
Supplementary Document | Uploaded 2020-09-21 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 242407 |  Pension Benefit Statement |
Other-Model | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0166 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202108-1210-004 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |