Information Collection Request
Special Financial Assistance by PBGC
ICR 202503-1212-001 · 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⚠️ Notice: This information collection may be outdated.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 Lock-in Applicatio Lock-In Application |
Form and Instruction | Unchanged | Available |
| Form Lock-in Applicatio Lock-In Application |
Form and Instruction | Unchanged | Repair queued |
| Form SFA Filing Instruc Notice of reinstatement |
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 | Available |
| Form SFA 300 Annual Statement of Compliance |
Form and Instruction | Unchanged | Repair queued |
| Form SFA 201 Application for Special Financial Assistance |
Form and Instruction | Modified | Repair queued |
| Form SFA 201 Application for Special Financial Assistance |
Form and Instruction | Modified | Repair queued |
 Justification Nonmaterial Change-amendment cover letter v01.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-19 | Available |
| Justification Nonmaterial Change-amendment cover letter v01.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-19 | Repair queued |
| Justification Nonmaterial Change - Checklist.02.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-07-02 | Available |
| Justification Nonmaterial Change - Checklist.02.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-07-02 | Repair queued |
 sfa-assumptions-guidance.pdf |
Supplementary Document | Uploaded 2024-03-27 | Available |
| sfa-assumptions-guidance.pdf |
Supplementary Document | Uploaded 2024-03-27 | Repair queued |
| Special Financial Assistance ICR (May 2024 Renewal) Supporting Statement.03.docx |
Supporting Statement A | Uploaded 2024-03-26 | Available |
| Special Financial Assistance ICR (May 2024 Renewal) Supporting Statement.03.docx |
Supporting Statement A | Uploaded 2024-03-26 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 254199 |  Lock-In Application |
Form and Instruction | Unchanged | |
| 254199 | Lock-In Application |
Form and Instruction | Unchanged | |
| 247988 | Requests for determination |
Unchanged | ||
| 247977 | Notice of reinstatement |
Form and Instruction | Unchanged | |
| 247977 | Notice of reinstatement |
Form and Instruction | Unchanged | |
| 247976 | Annual Statement of Compliance |
Form and Instruction | Unchanged | |
| 247976 | Annual Statement of Compliance |
Form and Instruction | Unchanged | |
| 247975 | Application for Special Financial Assistance |
Form and Instruction | Modified | |
| 247975 | Application for Special Financial Assistance |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | PBGC |
| OMB Control No | 1212-0074 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202407-1212-001 |
| Date Submitted to OIRA | 2025-03-19 |
| Requested Expiration Date | 1969-12-31 |