Locating and Paying Participants

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 703MP Roth Application for Elective Lump-Sum Payment - Roth Account	Form and Instruction	Modified	Available
Form 720MP Roth Application for Lump-Sum Payment Roth	Form and Instruction	Modified	Available
Form 714RBD Withdrawal of Employee Contributions – Non-Spouse Beneficiary	Form and Instruction	Modified	Available
Form 713RBD Election to Withdraw Employee Contributions, post RBD	Form and Instruction	Modified	Available
Form Form 722 Financial Statement of Debtor	Form and Instruction	Modified	Available
Form Form 720CD Application for Lump-Sum Payment (child or dependent)	Form and Instruction	Modified	Available
Form Form 720 Application for Lump-Sum Payment	Form and Instruction	Modified	Available
Form Form 717 Benefit Inquiry Questionnaire	Form and Instruction	Modified	Available
Form Form 716A Certification of Pension Plan Disability Status	Form and Instruction	Modified	Available
Form Form 716 Certification of Social Security Disability Status	Form and Instruction	Modified	Available
Form Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only	Form and Instruction	Modified	Available
Form Form 710 Application for Electronic Direct Deposit	Form and Instruction	Modified	Available
Form Form 708 Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits)	Form and Instruction	Modified	Available
Form Form 707 Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits)	Form and Instruction	Modified	Available
Form Form 706 Beneficiary Application for Pension Benefits - OF	Form and Instruction	Modified	Available
Form Form 705 Beneficiary Application for Pension Benefits	Form and Instruction	Modified	Available
Form Form 702 General Information Form	Form and Instruction	Modified	Available
Form Form 701 Payee Information Form	Form and Instruction	Modified	Available
Form Form 700 Participant Application for Pension Benefits	Form and Instruction	Modified	Available
Form Form 721T Tax Election for Payment Not Eligible for Rollover	Form and Instruction	Modified	Available
Form Form 721 Application for Eligible Rollover Payment – Non-Spouse Beneficiary	Form and Instruction	Modified	Available
Form Form 720MP Application for Lump-Sum Payment	Form and Instruction	Modified	Available
Form Form 715 Power of Attorney (POA)	Form and Instruction	Modified	Available
Form Form 714 Withdrawal of Employee Contributions – Non-Spouse Beneficiary	Form and Instruction	Modified	Repair queued
Form Form 713 Election to Withdraw Employee Contributions	Form and Instruction	Modified	Available
Form Form 712 Uniformed Services Information Form	Form and Instruction	Modified	Available
Form Form 704 Report of Earnings and Social Security Disability Information	Form and Instruction	Modified	Available
Form Form 703RBD-MP Application for Elective Lump-Sum Payment, post RBD	Form and Instruction	Modified	Available
Form Form 703RBD Application for Elective Lump-Sum Payment, post RBD	Form and Instruction	Modified	Available
Form Form 703MP Application for Elective Lump-Sum Payment	Form and Instruction	Modified	Available
Form Form 703 Application for Elective Lump-Sum Payment	Form and Instruction	Modified	Available
Form Form 700RSC Election of Retroactive Annuity Starting Date (Spousal Consent Required)	Form and Instruction	Modified	Available
Form Form 700RN Election of Retroactive Annuity Starting Date (Spousal Consent not Required)	Form and Instruction	Modified	Available
Form MyPBA MyPBA Screen Shots	Form and Instruction	Modified	Available
Form MyPBA Locating and Paying Participants	Form and Instruction	Modified	Repair queued
Your Benefit Your Choice - 706V Final Ver 022023.pdf	Supplementary Document	Uploaded 2024-05-20	Missing upstream
Your Benefit Your Choice - 700V Final Ver 022023.pdf	Supplementary Document	Uploaded 2024-05-20	Repair queued
Special Tax Notice 2024 version .pdf	Supplementary Document	Uploaded 2024-05-20	Repair queued
Roth Account Special Tax Notice Final- post OGC-OPD 01032023.pdf	Supplementary Document	Uploaded 2024-05-20	Missing upstream
Paperwork Reduction and Privacy Act 2024 v2 FINAL.docx	Supplementary Document	Uploaded 2024-05-20	Missing upstream
Paperwork Reduction and Privacy Act (Hardship) 2024 v2 FINAL.docx	Supplementary Document	Uploaded 2024-05-20	Repair queued
Acceptable Proofs of Age -2021.pdf	Supplementary Document	Uploaded 2024-05-20	Repair queued
Supporting statement paying and locating participants 2024 v8.docx	Supporting Statement A	Uploaded 2024-05-20	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Elective Lump-Sum Payment - Roth Account
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Lump-Sum Payment Roth
13603	Locating and Paying Participants	Form and Instruction	Modified	Withdrawal of Employee Contributions – Non-Spouse Beneficiary
13603	Locating and Paying Participants	Form and Instruction	Modified	Election to Withdraw Employee Contributions, post RBD
13603	Locating and Paying Participants	Form and Instruction	Modified	Financial Statement of Debtor
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Lump-Sum Payment (child or dependent)
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Modified	Benefit Inquiry Questionnaire
13603	Locating and Paying Participants	Form and Instruction	Modified	Certification of Pension Plan Disability Status
13603	Locating and Paying Participants	Form and Instruction	Modified	Certification of Social Security Disability Status
13603	Locating and Paying Participants	Form and Instruction	Modified	Change of Beneficiary for Certain & Continuous (C&C) Benefits Only
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Electronic Direct Deposit
13603	Locating and Paying Participants	Form and Instruction	Modified	Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits)
13603	Locating and Paying Participants	Form and Instruction	Modified	Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits)
13603	Locating and Paying Participants	Form and Instruction	Modified	Beneficiary Application for Pension Benefits - OF
13603	Locating and Paying Participants	Form and Instruction	Modified	Beneficiary Application for Pension Benefits
13603	Locating and Paying Participants	Form and Instruction	Modified	General Information Form
13603	Locating and Paying Participants	Form and Instruction	Modified	Payee Information Form
13603	Locating and Paying Participants	Form and Instruction	Modified	Participant Application for Pension Benefits
13603	Locating and Paying Participants	Form and Instruction	Modified	Tax Election for Payment Not Eligible for Rollover
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Eligible Rollover Payment – Non-Spouse Beneficiary
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Modified	Power of Attorney (POA)
13603	Locating and Paying Participants	Form and Instruction	Modified	Withdrawal of Employee Contributions – Non-Spouse Beneficiary
13603	Locating and Paying Participants	Form and Instruction	Modified	Election to Withdraw Employee Contributions
13603	Locating and Paying Participants	Form and Instruction	Modified	Uniformed Services Information Form
13603	Locating and Paying Participants	Form and Instruction	Modified	Report of Earnings and Social Security Disability Information
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Elective Lump-Sum Payment, post RBD
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Elective Lump-Sum Payment, post RBD
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Elective Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Modified	Application for Elective Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Modified	Election of Retroactive Annuity Starting Date (Spousal Consent Required)
13603	Locating and Paying Participants	Form and Instruction	Modified	Election of Retroactive Annuity Starting Date (Spousal Consent not Required)
13603	Locating and Paying Participants	Form and Instruction	Modified	MyPBA Screen Shots
13603	Locating and Paying Participants	Form and Instruction	Modified

ICR Details

OMB Control No: 1212-0055	ICR Reference No: 202405-1212-002
Status: Historical Active	Previous ICR Reference No: 202212-1212-002
Agency/Subagency: PBGC	Agency Tracking No:
Title: Locating and Paying Participants
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/25/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/21/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2027	36 Months From Approved	08/31/2024
Responses	136,081	0	170,506
Time Burden (Hours)	101,703	0	58,376
Cost Burden (Dollars)	60,742	0	58,682

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Abstract: This collection consists of information participants and beneficiaries are asked to provide in connection with an application for benefits or request for a benefit estimate. In addition, in some instances, as part of a search for participants and beneficiaries who may be entitled to benefits, the PBGC requests individuals to provide identifying information that the individual would provide as part of an initial contact with the PBGC.

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Authorizing Statute(s): PL: Pub.L. 109 - 280 410 Name of Law: Pension Protection Act of 2006
   US Code: 29 USC 1322, 1350 Name of Law: Employee Retirement Security Act (ERISA)
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 8725	02/08/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 43881	05/20/2024
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Locating and Paying Participants	Form 700RN, Form 700RSC, Form 703, Form 703MP, MyPBA, Form 703RBD, Form 703RBD-MP, Form 704, Form 712, Form 713, Form 714, Form 715, Form 720MP, Form 721, Form 721T, Form 706, Form 702, Form 707, Form 700, Form 701, Form 705, Form 708, Form 710, Form 711, Form 716, Form 716A, Form 717, Form 720, Form 720CD, Form 722, 713RBD, 714RBD, 720MP Roth, 703MP Roth	MyPBA Screen Shots ,   Election of Retroactive Annuity Starting Date (Spousal Consent not Required) ,   Election of Retroactive Annuity Starting Date (Spousal Consent Required) ,   Application for Elective Lump-Sum Payment ,   Application for Elective Lump-Sum Payment ,   Application for Elective Lump-Sum Payment, post RBD ,   Application for Elective Lump-Sum Payment, post RBD ,   Report of Earnings and Social Security Disability Information ,   Uniformed Services Information Form ,   Election to Withdraw Employee Contributions ,   Withdrawal of Employee Contributions – Non-Spouse Beneficiary ,   Power of Attorney (POA) ,   Application for Lump-Sum Payment ,   Application for Eligible Rollover Payment – Non-Spouse Beneficiary ,   Tax Election for Payment Not Eligible for Rollover ,   Participant Application for Pension Benefits ,   Payee Information Form ,   General Information Form ,   Beneficiary Application for Pension Benefits ,   Beneficiary Application for Pension Benefits - OF ,   Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits) ,   Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits) ,   Application for Electronic Direct Deposit ,   Change of Beneficiary for Certain & Continuous (C&C) Benefits Only ,   Certification of Social Security Disability Status ,   Certification of Pension Plan Disability Status ,   Benefit Inquiry Questionnaire ,   Application for Lump-Sum Payment ,   Application for Lump-Sum Payment (child or dependent) ,   Financial Statement of Debtor ,   Election to Withdraw Employee Contributions, post RBD ,   Withdrawal of Employee Contributions – Non-Spouse Beneficiary ,   Application for Lump-Sum Payment Roth ,   Application for Elective Lump-Sum Payment - Roth Account

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ICR Summary of Burden

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	136,081	170,506	0	0	-34,425	0
Annual Time Burden (Hours)	101,703	58,376	0	0	43,327	0
Annual Cost Burden (Dollars)	60,742	58,682	0	0	2,060	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: Changes in the estimated total average annual hour burden (from 58,376 to 101,703 hours) and cost burden (from $58,682 to $60,742) of this collection of information is attributable to higher hour burden estimates, based on information gathered from filers, higher average notary fees, and lower estimates of expected respondents (from 170,506 to 136,081), particularly from eliminating Form 719, “Election to Withhold Federal Income Tax from Periodic Payments.”

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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.     Yes

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.     Yes

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

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Common Form ICR:  No

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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: 05/21/2024

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