Information Collection Request

Special Financial Assistance by PBGC

ICR 202503-1212-001 · OMB 1212-0074 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Lock-in Applicatio Lock-in Application Form and Instruction Unchanged Available
Form Lock-in Applicatio Lock-In Application Form and Instruction Unchanged Repair queued
Form SFA Filing Instruc SFA Filing Instructions, Addendum B Form and Instruction Unchanged Available
Form SFA Filing Instruc Notice of reinstatement Form and Instruction Unchanged Repair queued
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Available
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Repair queued
Form SFA 100 SFA Application Checklist Form and Instruction Modified Available
Form SFA Template 10 SFA Template 10 Form and Instruction Modified Available
Form Model Certificatio Model Certification Form and Instruction Modified Available
Form Model Plan Amendme Model Plan Amendment, Reinstatement Form and Instruction Modified Available
Form Model Plan Amendme Model Plan Amendment Compliance Form and Instruction Modified Available
Form SFA Application Am SFA Application Amendment Cover Letter Form and Instruction Modified Available
Form PBGC E-filing Port PBGC E-filing Portal Form Modified Available
Form SFA 100-Supplement SFA Template Checklist, Supplemented Application Form and Instruction Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum D Form and Instruction Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum C Form and Instruction Modified Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum A Form and Instruction Modified Available
Form SFA 209 SFA Template 9 Form and Instruction Modified Available
Form SFA 206-A SFA Template 6A Form and Instruction Modified Available
Form SFA 208 SFA Template 8 Form and Instruction Modified Available
Form SFA 207 SFA Template 7 Form and Instruction Modified Available
Form SFA 206-B SFA Template 6B Form and Instruction Modified Available
Form SFA 205-B SFA Template 5B Form and Instruction Modified Available
Form SFA 205-A SFA Template 5A Form and Instruction Modified Available
Form SFA 204-B SFA Template 4B Form and Instruction Modified Available
Form SFA 204-A SFA Template 4A Form and Instruction Modified Available
Form SFA 203 SFA Template 3 Form and Instruction Modified Available
Form SFA 202 SFA Template 2 Form and Instruction Modified Available
Form SFA 201 SFA Template 1 Form and Instruction Modified Available
Form SFA 201 Application for Special Financial Assistance Form and Instruction Modified Repair queued
Justification Nonmaterial Change-amendment cover letter v01.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-19 Available
Justification Nonmaterial Change-amendment cover letter v01.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-03-19 Repair queued
Justification Nonmaterial Change - Checklist.02.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-07-02 Available
Justification Nonmaterial Change - Checklist.02.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-07-02 Repair queued
sfa-assumptions-guidance.pdf Supplementary Document Uploaded 2024-03-27 Available
sfa-assumptions-guidance.pdf Supplementary Document Uploaded 2024-03-27 Repair queued
Special Financial Assistance ICR (May 2024 Renewal) Supporting Statement.03.docx Supporting Statement A Uploaded 2024-03-26 Available
Special Financial Assistance ICR (May 2024 Renewal) Supporting Statement.03.docx Supporting Statement A Uploaded 2024-03-26 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
254199 Lock-In Application Form and Instruction UnchangedLock-in Application
254199 Lock-In Application Form and Instruction Unchanged
247988 Requests for determination Unchanged
247977 Notice of reinstatement Form and Instruction UnchangedSFA Filing Instructions, Addendum B
247977 Notice of reinstatement Form and Instruction Unchanged
247976 Annual Statement of Compliance Form and Instruction UnchangedAnnual Statement of Compliance
247976 Annual Statement of Compliance Form and Instruction Unchanged
247976 Annual Statement of Compliance Instruction Unchanged
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Application Checklist
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 10
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Certification
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Plan Amendment, Reinstatement
247975 Application for Special Financial Assistance Form and Instruction ModifiedModel Plan Amendment Compliance
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Application Amendment Cover Letter
247975 Application for Special Financial Assistance Form ModifiedPBGC E-filing Portal
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template Checklist, Supplemented Application
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum D
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum C
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Filing Instructions, Addendum A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 9
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 6A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 8
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 7
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 6B
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 5B
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 5A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 4B
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 4A
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 3
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 2
247975 Application for Special Financial Assistance Form and Instruction ModifiedSFA Template 1
247975 Application for Special Financial Assistance Form and Instruction Modified
247975 Application for Special Financial Assistance Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2027 05/31/2027 05/31/2027
207 0 207
864 0 864
1,931,800 0 1,931,800





Reginfo record details
5
table that charts list of burden
IC Title Form No. Form Name
Annual Statement of Compliance SFA 300
Application for Special Financial Assistance SFA 100-Supplemented, Model Plan Amendment, Reinstatement, SFA Template 10, PBGC E-filing Portal, SFA 100, SFA 201, SFA 202, SFA 203, SFA 204-A, SFA 204-B, SFA 206-B, SFA 205-A, SFA 205-B, SFA 209, SFA Filing Instructions, Addendum C, SFA 208, SFA 207, SFA 206-A, SFA Filing Instructions, Addendum A, SFA Filing Instructions, Addendum D, SFA Application Amendment Cover Letter, Model Certification, Model Plan Amendment Compliance ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Lock-In Application Lock-in Application
Notice of reinstatement SFA Filing Instructions, Addendum B
Requests for determination

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 207 207 0 0 0 0
Annual Time Burden (Hours) 864 864 0 0 0 0
Annual Cost Burden (Dollars) 1,931,800 1,931,800 0 0 0 0


Reginfo record details
  No