Notice of Failure to Make Required Contributions

OMB 1212-0041

To implement a statutory requirement, PBGC requires contributing sponsors and parents of parent-subsidiary controlled groups of which a contributing sponsor is a member to submit Form 200 to notify PBGC of failures to make required payments. PBGC uses this information to make decisions regarding enforcement of statutory liens.

The latest form for Notice of Failure to Make Required Contributions expires 2022-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form Form 200 Notice of Failure to Make Required Contributions Form
1212-0041 Supporting Statement 2024.03.docx Supporting Statement A
Justification Nonmaterial Change Form 200 LeapFile.02.docx Justification for No Material/Nonsubstantive Change
Notice of Failure to Make Required Contributions Form

All Historical Document Collections

202404-1212-002	Revision of a currently approved collection	2024-04-10
202310-1212-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-10-20
202106-1212-002 Approved without change	Revision of a currently approved collection	2021-06-14
201810-1212-002 Approved without change	Revision of a currently approved collection	2018-10-12
201509-1212-002 Approved without change	Revision of a currently approved collection	2015-09-11
201503-1212-006 Approved without change	Revision of a currently approved collection	2015-03-30
201302-1212-002 Comment filed on proposed rule and continue	Revision of a currently approved collection	2013-04-03
201204-1212-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2012-04-19
201202-1212-003 Approved without change	Extension without change of a currently approved collection	2012-02-15
200911-1212-001 Comment filed on proposed rule and continue	Revision of a currently approved collection	2009-11-25
200901-1212-005 Approved without change	Revision of a currently approved collection	2009-01-29
200512-1212-002 Approved without change	Extension without change of a currently approved collection	2005-12-23
200212-1212-001 Approved without change	Extension without change of a currently approved collection	2002-12-03
199909-1212-001 Approved without change	Extension without change of a currently approved collection	1999-09-03
199612-1212-002 Approved without change	No material or nonsubstantive change to a currently approved collection	1996-12-09
199607-1212-003 Approved without change	Revision of a currently approved collection	1996-07-23
199412-1212-005 Approved without change	Extension without change of a currently approved collection	1994-12-28
199411-1212-003 Approved with change	No material or nonsubstantive change to a currently approved collection	1994-11-08
199111-1212-001 Approved without change	New collection (Request for a new OMB Control Number)	1991-11-13