Annual Information Return/Report

OMB Control No: 1212-0026	ICR Reference No: 199810-1212-001
Status: Historical Active	Previous ICR Reference No: 199512-1212-003
Agency/Subagency: PBGC	Agency Tracking No:
Title: Annual Information Return/Report
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/30/1998
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/02/1998
Terms of Clearance: This approval covers continued use of the current version of this form through the 1998 plan year. OMB has approved a revised version of this form under a different control number for use beginning with plan year 1999.OMB's approval of this request is done with the understanding that the following will occur: 1. OMB staff will receive a briefing on the preliminary burden methodology study that was submitted as part of this request. 2. The final version of the methodology, as agreed to by OMB and the agencies, will be complete by May 31, 1999. 3. The results of the final burden methodology will be used in reestimating the burden of the current 5500 and revising the burden of the new Form 5500. 4. The agencies will continue to display the burden on the current version of the Form 5500 as in the past.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2002	02/28/2002
Responses	45,000	0	0
Time Burden (Hours)	5,639	0	0
Cost Burden (Dollars)	3,062,000	0	0

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Abstract: Sections 104 and 4065 of ERISA require plan administators to file an annual report. The report must contain the information described in section 103 of ERISA. The form 5500 series provides a standard format for fulfilling that requirement.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name Annual Information Return/Report 5500

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ICR Summary of Burden

	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	45,000	0	0	45,000	0	0
Annual Time Burden (Hours)	5,639	0	0	5,639	0	0
Annual Cost Burden (Dollars)	3,062,000	0	0	3,062,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(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;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
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.
Certification Date: 10/02/1998

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