Annual Information Return/Report

OMB Control No: 1210-0110	ICR Reference No: 200410-1210-001
Status: Historical Active	Previous ICR Reference No: 200108-1210-002
Agency/Subagency: DOL/EBSA	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: 12/22/2004
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/29/2004
Terms of Clearance: Approved as submitted for two years, because of the work underway to (1)speed up the processing of usable 5500 data and (2)further automate the submission and processing of the forms. Of course, changes in the processing of such data should be accompanied by rethinking (i.e., "reengineering") the data's collection, especially toward making the data more usable and reducing burden . In the first submission for this information collection on or after 5/2005, DOL and PBGC shall provide a plan and schedule to: (1) make the data more usable, (2) make the data more timely, ind icating the timeliness, and (3) reduce burden, indicating the burden reduction.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2007	36 Months From Approved	12/31/2004
Responses	837,755	0	863,682
Time Burden (Hours)	1,948,529	0	1,847,163
Cost Burden (Dollars)	663,870,000	0	546,789,000

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

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Authorizing Statute(s): US Code: 29 USC 1023 Name of Law: Employee Retirement Income Security Act of 1974

Citations for New Statutory Requirements: PL: Pub.L. 109 - 280 1103(b) Name of Law: Pension Protection Act of 2006

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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	837,755	863,682	0	0	-25,927	0
Annual Time Burden (Hours)	1,948,529	1,847,163	0	0	101,366	0
Annual Cost Burden (Dollars)	663,870,000	546,789,000	0	0	117,081,000	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: A reduction in burden was achieved through compliance with the requirements of Section 1103(b) of the Pension Protection Act of 2006.

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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

Agency Contact: Chris Cosby 202 693-8540

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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: 10/29/2004

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