Information Collection

Wage Reports and Pension Information

IC 9470 under ICR 202610-0960-002 · OMB 0960-0547.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
L99-C1.pdf	Other-Sample Correspondence Request
ERISA 902.pdf	Other-Other- Sample of Erisa Notices
ERISA 912.pdf	Other-Sample of ERISA Notices-912

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 422.122(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Electronic Capability
Other-Sample Correspondence Request	No	Paper Only
Other-Other- Sample of Erisa Notices-902	No	Paper Only
Other-Sample of ERISA Notices-912	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 178

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	178	-402	580
Annual IC Time Burden (Hours)	136	-338	474
Annual IC Cost Burden (Dollars)	0	0	0

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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