202601-1212-001CF RCF OMB: 1530-0069
OMB.report
OMB 1530-0069
RCF 202601-1212-001CF
( RCF Recertification )
Array
(
[refNbr] => 202601-1212-001CF
[obm] => 1530-0069
[icr] => 202507-1530-002
[status] => Active
[agency] => PBGC
[title] => ACH Vendor/Miscellaneous Payment Enrollment Form
[typeRCF] => RCF Recertification
[oiraAction] => Approved
[oiraNOA] => 1596380
[termsOfClearance] =>
[previousRCF] => 202208-1212-001CF
[agencyTrackingNo] =>
[conclusionDate] => 2026-01-16
[dateReceived] => 2026-01-16
)
Document
View RCF
- OIRA Conclusion
RCF ID: 202601-1212-001CFPrevious RCF ID: 202208-1212-001CF
Status:
Active
Expiration Date: 01/31/2029
Agency/Subagency: PBGCAgency Tracking No:
Host OMB Control No: 1530-0069Host ICR Reference No: 202507-1530-002
Title: ACH Vendor/Miscellaneous Payment Enrollment Form
Type of RCF: RCF Recertification
OIRA Conclusion Action: ApprovedConclusion Date:
01/16/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/16/2026
Terms of Clearance:
Description of Agency Usage:
Multiemployer plans that are eligible for special financial assistance under section 4262 of ERISA or multiemployer insurance program financial assistance under section 4261 of ERISA will complete this form to provide PBGC with the information necessary for electronic transfer of funds.
Authorizing Statute(s):
US Code:
29 USC 1361
Name of Law: Amounts payable by corporation
Pub.L. 117 - 2 9704
Name of Law: Special Financial Assistance Program for Financially Troubled Multiemployer Plans
Annual Cost to Federal Government: $0
Agency Contact:
Melissa Rifkin 202 326-4400 [email protected]
Common Form Information Collections (IC) in this RCF:
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
68
68
0
0
0
0
Annual Time Burden (Hours)
17
17
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement: