Information Collection

Grandfathered Plan Disclosure and Recordkeeping Requirement

IC 193127 under ICR 202412-1210-001 · OMB 1210-0140.

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Information Collection (IC) Details

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IC Title:	Grandfathered Plan Disclosure and Recordkeeping Requirement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 2590.715-1251(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160,584	Number of Respondents for Small Entity: 141,314

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

Percentage of Respondents Reporting Electronically: 58 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,991,000	-3,838,157	8,829,157
Annual IC Time Burden (Hours)	0	0	0
Annual IC Cost Burden (Dollars)	52,031	7,577	44,454

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.