Information Collection Request
Special Financial Assistance by PBGC-Withdrawal Liability Condition Exception
ICR 202301-1212-002 · OMB 1212-0074 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1212-0074 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form SFA Lock-In Applic Lock-In Application |
Form and Instruction | Unchanged | Available |
| Form SFA Filing Instruc Notice of reinstatement |
Form and Instruction | Unchanged | Repair queued |
| Form SFA 300 Annual Statement of Compliance |
Form and Instruction | Unchanged | Repair queued |
| Form SFA 201 Application for Special Financial Assistance |
Form and Instruction | Unchanged | Repair queued |
 Special Financial Assistance ICR (WDL exception) Supporting Statement.03.docx |
Supporting Statement A | Uploaded 2023-01-26 | Available |
| SFA FR Emergency Memo Jan 2023.02.docx |
Supplementary Document | Uploaded 2023-01-18 | Repair queued |
 Assumptions Guidance, 01 FORMATTED.pdf |
Supplementary Document | Uploaded 2022-11-28 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 254199 |  Lock-In Application |
Form and Instruction | Unchanged | |
| 247988 | Requests for determination |
Modified | ||
| 247977 | Notice of reinstatement |
Form and Instruction | Unchanged | |
| 247976 | Annual Statement of Compliance |
Form and Instruction | Unchanged | |
| 247975 | Application for Special Financial Assistance |
Form and Instruction | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | PBGC |
| OMB Control No | 1212-0074 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202211-1212-003 |
| Date Submitted to OIRA | 2023-01-26 |
| Requested Expiration Date | 2023-01-26 |