Information Collection Request

Special Financial Assistance by PBGC

ICR 202605-1212-001 · OMB 1212-0074 · 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 Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum B Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum B Form and Instruction Unchanged Available
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Available
Form SFA 300 Annual Statement of Compliance Form and Instruction Unchanged Available
Form SFA 100 SFA Application Checklist Form and Instruction Unchanged Available
Form SFA 100 SFA Application Checklist Form and Instruction Unchanged Available
Form SFA Template 10 SFA Template 10 Form and Instruction Unchanged Available
Form SFA Template 10 SFA Template 10 Form and Instruction Unchanged Available
Form Model Certificatio Model Certification Form and Instruction Unchanged Available
Form Model Certificatio Model Certification Form and Instruction Unchanged Available
Form Model Plan Amendme Model Plan Amendment, Reinstatement Form and Instruction Unchanged Available
Form Model Plan Amendme Model Plan Amendment, Reinstatement Form and Instruction Unchanged Available
Form Model Plan Amendme Model Plan Amendment Compliance Form and Instruction Unchanged Available
Form Model Plan Amendme Model Plan Amendment Compliance Form and Instruction Unchanged Available
Form SFA Application Am SFA Application Amendment Cover Letter Form and Instruction Unchanged Available
Form SFA Application Am SFA Application Amendment Cover Letter Form and Instruction Unchanged Available
Form PBGC E-filing Port PBGC E-filing Portal Form Unchanged Available
Form PBGC E-filing Port PBGC E-filing Portal Form Unchanged Available
Form SFA 100-Supplement SFA Template Checklist, Supplemented Application Form and Instruction Unchanged Available
Form SFA 100-Supplement SFA Template Checklist, Supplemented Application Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum D Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum D Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum C Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum C Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum A Form and Instruction Unchanged Available
Form SFA Filing Instruc SFA Filing Instructions, Addendum A Form and Instruction Unchanged Available
Form SFA 209 SFA Template 9 Form and Instruction Unchanged Available
Form SFA 209 SFA Template 9 Form and Instruction Unchanged Available
Form SFA 206-A SFA Template 6A Form and Instruction Unchanged Available
Form SFA 206-A SFA Template 6A Form and Instruction Unchanged Available
Form SFA 208 SFA Template 8 Form and Instruction Unchanged Available
Form SFA 208 SFA Template 8 Form and Instruction Unchanged Available
Form SFA 207 SFA Template 7 Form and Instruction Unchanged Available
Form SFA 207 SFA Template 7 Form and Instruction Unchanged Available
Form SFA 206-B SFA Template 6B Form and Instruction Unchanged Available
Form SFA 206-B SFA Template 6B Form and Instruction Unchanged Available
Form SFA 205-B SFA Template 5B Form and Instruction Unchanged Available
Form SFA 205-B SFA Template 5B Form and Instruction Unchanged Available
Form SFA 205-A SFA Template 5A Form and Instruction Unchanged Available
Form SFA 205-A SFA Template 5A Form and Instruction Unchanged Available
Form SFA 204-B SFA Template 4B Form and Instruction Unchanged Available
Form SFA 204-B SFA Template 4B Form and Instruction Unchanged Available
Form SFA 204-A SFA Template 4A Form and Instruction Unchanged Available
Form SFA 204-A SFA Template 4A Form and Instruction Unchanged Available
Form SFA 203 SFA Template 3 Form and Instruction Unchanged Available
Form SFA 203 SFA Template 3 Form and Instruction Unchanged Available
Form SFA 202 SFA Template 2 Form and Instruction Unchanged Available
Form SFA 202 SFA Template 2 Form and Instruction Unchanged Available
Form SFA 201 SFA Template 1 Form and Instruction Unchanged Available
Form SFA 201 SFA Template 1 Form and Instruction Unchanged Available
SFA Merger WDL Illustrative Calculations-2026.02.05_To_OGC.xlsx Supplementary Document Uploaded 2026-05-08 Available
SFA Merger WDL Illustrative Calculations-2026.02.05_To_OGC.xlsx Supplementary Document Uploaded 2026-05-08 Available
Justification Nonmaterial Change_1212-0074 Mergers Amendment and FAQs 5.05.26 CLEAN ltt.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-05-08 Available
Justification Nonmaterial Change_1212-0074 Mergers Amendment and FAQs 5.05.26 CLEAN ltt.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-05-08 Available
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 Available
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 Available
sfa-assumptions-guidance.pdf Supplementary Document Uploaded 2024-03-27 Available
sfa-assumptions-guidance.pdf Supplementary Document Uploaded 2024-03-27 Available
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 Available

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 UnchangedLock-in Application
247988 Requests for determination Unchanged
247977 Notice of reinstatement Form and Instruction UnchangedSFA Filing Instructions, Addendum B
247977 Notice of reinstatement Form and Instruction UnchangedSFA Filing Instructions, Addendum B
247976 Annual Statement of Compliance Form and Instruction UnchangedAnnual Statement of Compliance
247976 Annual Statement of Compliance Form and Instruction UnchangedAnnual Statement of Compliance
247976 Annual Statement of Compliance Instruction Unchanged
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Application Checklist
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Application Checklist
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 10
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 10
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Certification
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Certification
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Plan Amendment, Reinstatement
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Plan Amendment, Reinstatement
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Plan Amendment Compliance
247975 Application for Special Financial Assistance Form and Instruction UnchangedModel Plan Amendment Compliance
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Application Amendment Cover Letter
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Application Amendment Cover Letter
247975 Application for Special Financial Assistance Form UnchangedPBGC E-filing Portal
247975 Application for Special Financial Assistance Form UnchangedPBGC E-filing Portal
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template Checklist, Supplemented Application
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template Checklist, Supplemented Application
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum D
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum D
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum C
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum C
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Filing Instructions, Addendum A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 9
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 9
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 6A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 6A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 8
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 8
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 7
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 7
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 6B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 6B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 5B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 5B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 5A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 5A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 4B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 4B
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 4A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 4A
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 3
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 3
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 2
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 2
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 1
247975 Application for Special Financial Assistance Form and Instruction UnchangedSFA Template 1
247975 Application for Special Financial Assistance Instruction Unchanged

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 201, SFA 202, SFA 203, SFA 204-A, SFA 204-B, SFA 206-B, SFA 205-A, SFA 205-B, SFA 209, SFA 208, SFA 207, SFA 206-A, SFA Filing Instructions, Addendum A, Model Plan Amendment Compliance, SFA Filing Instructions, Addendum C, SFA Filing Instructions, Addendum D, SFA Application Amendment Cover Letter, Model Certification, SFA 100-Supplemented, Model Plan Amendment, Reinstatement, SFA Template 10, PBGC E-filing Portal, SFA 100 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
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
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