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Federal forms, ICRs, and supporting documents

Information Collection Request

ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLANS, FORM 5500 LINE ITEMS 35(B)(IV) AND (V) AND INSTRUCTIONS WITH REGARD TO THOSE ITEMS ONLY

ICR 198910-1210-001 · OMB 1210-0016 · Historical Active

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IC IDCollectionTypeStatusForm
121460 ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLANS, FORM 5500 LINE ITEMS 35(B)(IV) AND (V) AND INSTRUCTIONS WITH REGARD TO THOSE ITEMS ONLY Form Migrated
ICR Details
1210-0016 198910-1210-001
Historical Active 198904-1210-002
DOL/EBSA
ANNUAL RETURN/REPORT OF EMPLOYEE BENEFIT PLANS, FORM 5500 LINE ITEMS 35(B)(IV) AND (V) AND INSTRUCTIONS WITH REGARD TO THOSE ITEMS ONLY
Revision of a currently approved collection   No
Regular
Approved without change 01/11/1990
Retrieve Notice of Action (NOA) 10/12/1989
  Inventory as of this Action Requested Previously Approved
11/30/1991 11/30/1991 01/31/1991
900,000 0 900,000
1,086,970 0 953,637
0 0 0
THE FORM 5500, LINE ITEMS 35(B)(IV) AND (V) REQUIRE THE REPORTING OF THE PLAN'S REALIZED AND UNREALIZED GAINS AND LOSSES FOR THE PLAN YEAR.
None
None
No
  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 900,000 900,000 0 0 0 0
Annual Time Burden (Hours) 1,086,970 953,637 0 0 133,333 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/12/1989