Information Collection

Administrative Appeals

IC 46311 under ICR 202506-1212-002 · OMB 1212-0061.

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Information Collection (IC) Details

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IC Title:	Administrative Appeals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 4003 Subpart D

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: PBGC - 10: Administrative Appeals Files	FR Citation: 83 FR 6247

Number of Respondents: 132	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	132	-243	375
Annual IC Time Burden (Hours)	105	-188	293
Annual IC Cost Burden (Dollars)	9,000	-28,400	37,400

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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