Information Collection Request

Annual Information Return/Report

ICR 202504-1212-006 · OMB 1212-0057 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form Schedule SB 2025 Schedule SB Form Modified Available
Form Schedule R 2025 Schedule R Form Modified Repair queued
Form Schedule MEP 2025 Schedule MEP Form Modified Available
Form Schedule MB 2025 Schedule MB Form Modified Repair queued
Form Schedule I 2025 Schedule I Form Modified Available
Form Schedule H 2025 Schedule H Form Modified Repair queued
Form Schedule G 2025 Schedule G Form Modified Repair queued
Form Schedule DCG 2025 Schedule DCG Form Modified Available
Form Schedule D 2025 Schedule D Form Modified Available
Form Schedule C 2025 Schedule C Form Modified Available
Form Form 5500-SF 2025 Form 5500-SF Form Modified Available
Form Form 5500 2025 Form 5500 Form Modified Available
Form Schedule A 2025 Schedule A Form Modified Repair queued
2023 PBGC Supporting Statement v.5 (2.27.23) .docx Supporting Statement A Uploaded 2025-04-23 Repair queued
2023 PBGC Supporting Statement v.5 (2.27.23) .docx Supporting Statement A Uploaded 2025-04-23 Repair queued
2025 Justification Nonmaterial Change Documentation for Form 5500 v.05.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-18 Repair queued
2025 Justification Nonmaterial Change Documentation for Form 5500 v.05.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-04-18 Repair queued
2024 Justification Nonmaterial Change Documentation for Form 5500 v.05.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-04-03 Repair queued
2024 Justification Nonmaterial Change Documentation for Form 5500 v.05.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-04-03 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
13607 Annual Information Return/Report Form Modified2025 Schedule SB
13607 Annual Information Return/Report Form Modified2025 Schedule R
13607 Annual Information Return/Report Form Modified2025 Schedule MEP
13607 Annual Information Return/Report Form Modified2025 Schedule MB
13607 Annual Information Return/Report Form Modified2025 Schedule I
13607 Annual Information Return/Report Form Modified2025 Schedule H
13607 Annual Information Return/Report Form Modified2025 Schedule G
13607 Annual Information Return/Report Form Modified2025 Schedule DCG
13607 Annual Information Return/Report Form Modified2025 Schedule D
13607 Annual Information Return/Report Form Modified2025 Schedule C
13607 Annual Information Return/Report Form Modified2025 Form 5500-SF
13607 Annual Information Return/Report Form Modified2025 Form 5500
13607 Annual Information Return/Report Form Modified2025 Schedule A
13607 Annual Information Return/Report Instruction Modified
ICR Details
1212-0057 202504-1212-006
Active 202403-1212-004
PBGC
Annual Information Return/Report
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 04/29/2025
Retrieve Notice of Action (NOA) 04/23/2025
  Inventory as of this Action Requested Previously Approved
03/31/2026 03/31/2026 03/31/2026
25,000 0 25,000
15,089 0 15,089
0 0 0

Sections 104 and 4065 of ERISA require plan administrators to file an annual report. The report must contain the information described in section 103 of ERISA. The Form 5500 Series provides a standard format for fulfilling that requirement.

US Code: 29 USC 1302(b)(3), 1365 Name of Law: ERISA
  
Statute at Large: 120 Stat. 780 Name of Statute: Pension Protection Act of 2006

1210-AB97 Final or interim final rulemaking 88 FR 11984 02/24/2023

No

1
IC Title Form No. Form Name
Annual Information Return/Report Schedule A, Form 5500-SF, Form 5500, Schedule C, Schedule D, Schedule DCG, Schedule G, Schedule I, Schedule H, Schedule MB, Schedule MEP, Schedule R, Schedule SB 2025 Schedule A ,   2025 Form 5500 ,   2025 Form 5500-SF ,   2025 Schedule C ,   2025 Schedule D ,   2025 Schedule DCG ,   2025 Schedule G ,   2025 Schedule H ,   2025 Schedule I ,   2025 Schedule MB ,   2025 Schedule MEP ,   2025 Schedule R ,   2025 Schedule SB

  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 25,000 25,000 0 0 0 0
Annual Time Burden (Hours) 15,089 15,089 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    No
    No
No
No
No
No
Karen Levin 202 326-4400 ext. 3559 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/23/2025