Information Collection

Reportable Events

IC 13522 under ICR 202404-1212-001 · OMB 1212-0013.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0013 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 10 Reportable Events	Form
2024 Form 10-Advance Instructions.pdf	Instruction
2024 Form 10-Advance Instructions.pdf	Instruction
2024 Form 10 Instructions.pdf	Instruction
2024 Form 10 Instructions.pdf	Instruction
eFiling Portal User Guide_Reportable Events.pdf	Other-Screenshots
eFiling Portal User Guide_Reportable Events.pdf	Other-Screenshots
Form 10 Post-Event Notice of Reportable Events 2024 Form 10.pdf	Form
Form 10 Post-Event Notice of Reportable Events 2024 Form 10.pdf	Form
Form 10-Advance Advance Notice of Reportable Events 2024 Form 10-Advance.pdf	Form
Form 10-Advance Advance Notice of Reportable Events 2024 Form 10-Advance.pdf	Form

IC Title:

Reportable Events

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 4043

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 10	Post-Event Notice of Reportable Events	2024 Form 10.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 10-Advance	Advance Notice of Reportable Events	2024 Form 10-Advance.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2024 Form 10-Advance Instructions.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2024 Form 10 Instructions.pdf	Yes	Yes	Fillable Fileable Signable
Other-Screenshots			eFiling Portal User Guide_Reportable Events.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 438

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	438	-135	573
Annual IC Time Burden (Hours)	1,377	-425	1,802
Annual IC Cost Burden (Dollars)	326,310	-100,575	426,885

Documents for IC

table that charts IC Documents
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.