Information Collection

Reportable Events

IC 13522 under ICR 201810-1212-003 · OMB 1212-0013.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0013 can be found here:

Documents and Forms

Document Name Document Type
2018 Form Changes_Form 10 instructions_30-day clean.pdf Instruction
2018 Form Changes_Form 10Advance instructions_30-day clean.pdf Instruction
Form 10 Post-Event Notice of Reportable Events Form 10 redline 30-day.pdf Form
From 10-Advance Advance Notice of Reportable Events 2018 Form 10Advance_30-day.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reportable Events	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2018 Form Changes_Form 10 instructions_30-day clean.pdf	Yes	Yes	Fillable Fileable Signable
Form	Form 10	Post-Event Notice of Reportable Events	Form 10 redline 30-day.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			2018 Form Changes_Form 10Advance instructions_30-day clean.pdf	Yes	Yes	Fillable Fileable Signable
Form	From 10-Advance	Advance Notice of Reportable Events	2018 Form 10Advance_30-day.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 590	Number of Respondents for Small Entity: 286

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	590	-226	816
Annual IC Time Burden (Hours)	1,855	-2,641	4,496
Annual IC Cost Burden (Dollars)	439,550	-168,020	607,570

Documents for IC

Title	Document	Date Uploaded
No associated records found

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