Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Appendix 1 Appendix 1 - 4010 Illustrative form	Form	Modified	Available
Form Appendix 1 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Form	Modified	Repair queued
Justification Nonmaterial Change 4010 instructions.v2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-01-16	Repair queued
Justification Nonmaterial Change 4010 instructions.v2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-01-16	Repair queued
Justification Nonmaterial Change 4010 instructions.v6.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-07-08	Repair queued
Justification Nonmaterial Change 4010 instructions.v6.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-07-08	Missing upstream
Justification Nonmaterial Change 4010 instructions.v1.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-18	Repair queued
Justification Nonmaterial Change 4010 instructions.v1.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-01-18	Repair queued
4010 ICR Supporting Statement 2022.04.docx	Supporting Statement A	Uploaded 2023-01-17	Available
4010 ICR Supporting Statement 2022.04.docx	Supporting Statement A	Uploaded 2023-01-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13583	Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Form	Modified	Appendix 1 - 4010 Illustrative form
13583	Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Form	Modified
13583	Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Other-screenshots	Modified

ICR Details

OMB Control No: 1212-0049	ICR Reference No: 202501-1212-001
Status: Historical Active	Previous ICR Reference No: 202407-1212-002
Agency/Subagency: PBGC	Agency Tracking No:
Title: Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/17/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/16/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2026	02/28/2026	02/28/2026
Responses	400	0	400
Time Burden (Hours)	800	0	800
Cost Burden (Dollars)	11,080,000	0	11,080,000

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Abstract: ERISA section 4010 requires the annual reporting of actuarial and financial information by controlled groups that sponsor pension plans that have significant underfunding. PBGC uses this information to detect and monitor financial problems with the controlled groups and to respond quickly when it learns that a controlled group intends to engage in a transaction that may reduce the assets available to pay plan liabilities.

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Authorizing Statute(s): US Code: 29 USC 1310 Name of Law: 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:
	87 FR 67078	11/07/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 2646	01/17/2023
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
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	Appendix 1	Appendix 1 - 4010 Illustrative form

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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	400	400	0	0	0	0
Annual Time Burden (Hours)	800	800	0	0	0	0
Annual Cost Burden (Dollars)	11,080,000	11,080,000	0	0	0	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:

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Annual Cost to Federal Government: $22,000

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.     No

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.     No

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: 01/16/2025

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