Information Collection

Lock-In Application

IC 254199 under ICR 202605-1212-001 · OMB 1212-0074.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Lock-in Applicatio Lock-in Application Lock-In Application	Form and Instruction
Form Lock-in Applicatio Lock-in Application Lock-In Application	Form and Instruction
Lock-in Applicatio Lock-in Application lock-in-application.pdf www.pbgc.gov/sites/default/files/sfa/lock-in-application.pdf	Form and Instruction
Lock-in Applicatio Lock-in Application lock-in-application.pdf www.pbgc.gov/sites/default/files/sfa/lock-in-application.pdf	Form and Instruction

IC Title:

Lock-In Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 4262

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Lock-in Application			https://www.pbgc.gov/sites/default/files/sfa/lock-in-application.pdf	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: PBGC â 19: Office of General Counsel Case Management System

FR Citation: 83 FR 6247

Number of Respondents: 6

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	6	6
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	4,800	4,800

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].