Information Collection

ERISA Summary Annual Report Requirement

IC 13341 under ICR 202602-1210-002 · OMB 1210-0040.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Model Summary Annual Report Relating to Pension Plans 2-24-2023 ROCIS.docx	Other-Model Form for Pension Plans
Model Summary Annual Report Relating to Welfare Plans 2-24-2023 ROCIS.docx	Other-Model Form for Welfare Plans
Model Summary Annual Report Relating to Pension Plans for plan year 2022.docx	Other-Model Form for Pension Plans f
Model Summary Annual Report Relating to Welfare Plans for plan year 2022.docx	Other-Model Form for Welfare Plans f

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2520.104(b)-1(b) 29 CFR 2520.104(b)-1(c) 29 CFR 2520.104b-10

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Model Form for Pension Plans	Yes	No	Fillable Printable
Other-Model Form for Welfare Plans	Yes	No	Fillable Printable
Other-Model Form for Pension Plans for plan year 2022	Yes	No	Fillable Printable
Other-Model Form for Welfare Plans for plan year 2022	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 839,758

Number of Respondents for Small Entity: 689,736

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 96 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	209,869,516	31,657,967	178,211,549
Annual IC Time Burden (Hours)	15,209,906	14,141,584	1,068,322
Annual IC Cost Burden (Dollars)	46,945,095	28,521,976	18,423,119

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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