OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

ICR 202501-1212-001 · OMB 1212-0049 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form Appendix 1 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form Modified Repair queued
Justification Nonmaterial Change 4010 instructions.v2.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-01-16 Repair queued
Justification Nonmaterial Change 4010 instructions.v6.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-07-08 Repair queued
Justification Nonmaterial Change 4010 instructions.v1.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-01-18 Repair queued
4010 ICR Supporting Statement 2022.04.docx Supporting Statement A Uploaded 2023-01-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
13583 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form Modified
ICR Details
1212-0049 202501-1212-001
Received in OIRA 202407-1212-002
PBGC
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
No material or nonsubstantive change to a currently approved collection   No
Regular 01/16/2025
  Requested Previously Approved
02/28/2026 02/28/2026
400 400
800 800
11,080,000 11,080,000
ERISA section 4010 requires the annual reporting of actuarial and financial information by controlled groups that sponsor pension plans that have significant underfunding. PBGC uses this information to detect and monitor financial problems with the controlled groups and to respond quickly when it learns that a controlled group intends to engage in a transaction that may reduce the assets available to pay plan liabilities.
US Code: 29 USC 1310 Name of Law: ERISA
  
None
Not associated with rulemaking
  87 FR 67078 11/07/2022
88 FR 2646 01/17/2023
No
1
IC Title Form No. Form Name
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Appendix 1 Appendix 1 - 4010 Illustrative form
  Total Request 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 400 400 0 0 0 0
Annual Time Burden (Hours) 800 800 0 0 0 0
Annual Cost Burden (Dollars) 11,080,000 11,080,000 0 0 0 0
No
No
$22,000
No
    No
    No
No
No
No
No
Gregory Katz 202 326-3829 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/16/2025