Information Collection

Settlement Agreements Between a Plan and Party in Interest

IC 13416 under ICR 202501-1210-006 · OMB 1210-0091.

Documents and Forms

Information Collection (IC) Details

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IC Title:	Settlement Agreements Between a Plan and Party in Interest	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PTE 94-71			PTE 94-71.doc		Yes	No	Printable Only
Other-PTE 2003-39			pte 2003-39.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 3

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 96 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	567	-243	810
Annual IC Time Burden (Hours)	5	-11	16
Annual IC Cost Burden (Dollars)	17	-197	214

Documents for IC

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