Information Collection

Survey of Multiemployer Pension Plan Withdrawal Liability Information

IC 232801 under ICR 201808-1212-001 · OMB 1212-0071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0071 can be found here:

Documents and Forms

Document Name Document Type
Copy of Withdrawal Liability Survey Template 10-19-18.xlsx Other-Survey Template
Withdrawal Liability Survey Paperwork Reduction Act Notice.docx Withdrawal Liability Survey PRA Notice IC Document
Sample cover email withdrawal liability survey.docx Sample Cover Email for Withdrawal Liability Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey of Multiemployer Pension Plan Withdrawal Liability Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Template			Copy of Withdrawal Liability Survey Template 10-19-18.xlsx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 65	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65	65
Annual IC Time Burden (Hours)	650	650
Annual IC Cost Burden (Dollars)	260,000	260,000

Documents for IC

Title	Document	Date Uploaded
Withdrawal Liability Survey PRA Notice	Withdrawal Liability Survey Paperwork Reduction Act Notice.docx	10/31/2018
Sample Cover Email for Withdrawal Liability Survey	Sample cover email withdrawal liability survey.docx	10/31/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.