Information Collection Request
Request for Assistance from the Department of Labor, Employee Benefits Security Administration
ICR 202401-1210-003 · OMB 1210-0146 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1210-0146 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 301 Customer Service Intake Form |
Form and Instruction | Modified | Missing upstream |
 1210-0146 Supporting Statement Web Intake Form 02-09-24.docx |
Supporting Statement A | Uploaded 2024-02-09 | Missing upstream |
| 1210-0146 Online inquiry form nonsubstantive change July 2022 Final.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-07-15 | Repair queued |
 page 4 Screenshot 2022-07-15 100647.png |
Supplementary Document | Uploaded 2022-07-15 | Repair queued |
| inquiry form page 3 part 2 Screenshot 2022-07-15 100406.png |
Supplementary Document | Uploaded 2022-07-15 | Repair queued |
| inquiry form page 3 Screenshot 2022-07-15 100047.png |
Supplementary Document | Uploaded 2022-07-15 | Repair queued |
| inquiry form page 2 part 2 Screenshot 2022-07-15 095841.png |
Supplementary Document | Uploaded 2022-07-15 | Repair queued |
| inquiry form page 2 Screenshot 2022-07-15 095245.png |
Supplementary Document | Uploaded 2022-07-15 | Missing upstream |
| ask-ebsa-form-mock-up.png |
Supplementary Document | Uploaded 2022-07-13 | Missing upstream |
 30-day FRN (1210-0146) published.pdf |
Supplementary Document | Uploaded 2021-01-14 | Missing upstream |
| 29 U.S. Code § 1134 - Investigative authority.pdf |
Supplementary Document | Uploaded 2021-01-07 | Repair queued |
| 29 U.S. Code § 1143 - Research, studies, and reports _ U.S. Code _ US Law _ LII _ Legal Information Institute.pdf |
Supplementary Document | Uploaded 2021-01-07 | Repair queued |
| 60-day FRN (1210-0146) published.pdf |
Supplementary Document | Uploaded 2021-01-07 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 198333 |  Customer Service Intake Form |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0146 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202207-1210-002 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |