Information Collection Request

Notice of Insolvency (29 CFR Part 4245)

ICR 202504-1212-008 · OMB 1212-0033 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 003 Combined Notice of Insolvency and Notice of Insolvency Benefit Level Form and Instruction Modified Available
Form 002 Notice of Insolvency Form Modified Available
Form 001 Notice of Insolvency Benefit Level Form Modified Repair queued
Form 001 Notice of Insolvency (29 CFR Part 4245) Form Modified Missing upstream
Supporting statement part 4245 2025 v3.docx Supporting Statement A Uploaded 2025-04-30 Available
Supporting statement part 4245 2025 v3.docx Supporting Statement A Uploaded 2025-04-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
13555 Notice of Insolvency (29 CFR Part 4245) Instruction Modified
13555 Notice of Insolvency (29 CFR Part 4245) Form and Instruction ModifiedCombined Notice of Insolvency and Notice of Insolvency Benefit Level
13555 Notice of Insolvency (29 CFR Part 4245) Form ModifiedNotice of Insolvency
13555 Notice of Insolvency (29 CFR Part 4245) Form ModifiedNotice of Insolvency Benefit Level
13555 Notice of Insolvency (29 CFR Part 4245) Form Modified
ICR Details
1212-0033 202504-1212-008
Active 202205-1212-006
PBGC
Notice of Insolvency (29 CFR Part 4245)
Extension without change of a currently approved collection   No
Regular
Approved without change 06/25/2025
Retrieve Notice of Action (NOA) 05/19/2025
  Inventory as of this Action Requested Previously Approved
06/30/2028 36 Months From Approved 06/30/2025
1,038 0 1,038
16 0 16
10,000 0 10,000

These notices, mandated by section 4245(e) of the Employee Retirement Income Security Act of 1974 and 29 CFR Part 2674, provide information PBGC needs to estimate cash requirements for financial assistance to troubled mutliemployer pension plans, and other interested parties need for financial planning or to bargain over contribution increases. Multiemployer plans that are or may become insolvent give these notices.

US Code: 29 USC 1441 Name of Law: ERISA
  
None

Not associated with rulemaking

  90 FR 11630 03/10/2025
90 FR 21084 05/15/2025
No

  Total Approved 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 1,038 1,038 0 0 0 0
Annual Time Burden (Hours) 16 16 0 0 0 0
Annual Cost Burden (Dollars) 10,000 10,000 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
No
Hilary Duke 202 326-4000 ext. 3839 [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.
05/19/2025