Special Financial Assistance by PBGC

OMB Control No: 1212-0074	ICR Reference No: 202605-1212-001
Status: Active	Previous ICR Reference No: 202503-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Special Financial Assistance by PBGC
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/11/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/08/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2027	05/31/2027	05/31/2027
Responses	207	0	207
Time Burden (Hours)	864	0	864
Cost Burden (Dollars)	1,931,800	0	1,931,800

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Abstract: Under section 4262 of the Employee Retirement Income Security Act of 1974 (ERISA) PBGC administers a Special Financial Assistance program for financially troubled multiemployer plans. The statute sets forth the requirements for this program, including specifying which plans are eligible to apply, the cutoff date for applications, actuarial assumptions, determinations on applications, restrictions and conditions on plans that receive SFA, and the requirements for certain plans with suspended benefits to reinstate those benefits and provide make-up payments to restore previously suspended benefits. Unlike financial assistance under section 4261 of ERISA, which is provided in the form of a loan and in periodic payments, a plan receiving SFA under section 4262 has no obligation to repay SFA. This information collection contains the requirements necessary to implement the SFA program and to provide proper stewardship of taxpayer funds. These information requirements include: • An application for SFA (including calculating the amount of SFA) that the plan sponsor of an eligible multiemployer plan must file with PBGC to receive payment of SFA. PBGC needs the information in the application to review a plan’s eligibility for SFA, priority group status (if applicable), and amount of requested SFA. • A lock-in application that plan may, but is not required, to use to lock in its base data. PBGC needs the information in the lock-in application to garner a plan's base data when the plan files a full application for SFA> • An Annual Statement of Compliance (with the restrictions and conditions under section 4262 of ERISA and 29 CFR part 4262) that a plan that has received SFA is required to file with PBGC. PBGC needs the information in the Annual Statement of Compliance to ensure that a plan is compliant with the imposed restrictions and conditions. • A notice of reinstatement that a plan sponsor of a plan with benefits that were suspended under sections 305(e)(9) or 4245(a) of ERISA must issue to participants and beneficiaries whose benefits are reinstated. Participants and beneficiaries need the notice of reinstatement to better understand the calculation and timing of their reinstated benefits and, if applicable, make-up payments. • A request for a determination from PBGC for approval for an exception under certain circumstances for SFA conditions under § 4262.16 relating to reductions in contributions, transfers or mergers, benefit increases, and settlement of withdrawal liability. PBGC needs the information required for a request for determination to determine whether to approve an exception from the specified condition.

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Authorizing Statute(s): PL: Pub.L. 117 - 2 9704 Name of Law: American Rescue Plan Act of 2021

Citations for New Statutory Requirements: US Code: 29 USC 1432 Name of Law: American Rescue Plan Act of 2021

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 88138	12/20/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 21544	03/28/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title Form No. Form Name Annual Statement of Compliance SFA 300 Annual Statement of Compliance Application for Special Financial Assistance SFA 201, SFA 202, SFA 203, SFA 204-A, SFA 204-B, SFA 206-B, SFA 205-A, SFA 205-B, SFA 209, SFA 208, SFA 207, SFA 206-A, SFA Filing Instructions, Addendum A, Model Plan Amendment Compliance, SFA Filing Instructions, Addendum C, SFA Filing Instructions, Addendum D, SFA Application Amendment Cover Letter, Model Certification, SFA 100-Supplemented, Model Plan Amendment, Reinstatement, SFA Template 10, PBGC E-filing Portal, SFA 100 SFA Template 1 ,   SFA Template 2 ,   SFA Template 3 ,   SFA Template 4A ,   SFA Template 4B ,   SFA Template 5A ,   SFA Template 5B ,   SFA Template 6B ,   SFA Template 7 ,   SFA Template 8 ,   SFA Template 6A ,   SFA Template 9 ,   SFA Filing Instructions, Addendum A ,   SFA Filing Instructions, Addendum C ,   SFA Filing Instructions, Addendum D ,   SFA Template Checklist, Supplemented Application ,   PBGC E-filing Portal ,   SFA Application Amendment Cover Letter ,   Model Plan Amendment Compliance ,   Model Plan Amendment, Reinstatement ,   Model Certification ,   SFA Template 10 ,   SFA Application Checklist Lock-In Application Lock-in Application Lock-in Application Notice of reinstatement SFA Filing Instructions, Addendum B SFA Filing Instructions, Addendum B Requests for determination

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ICR Summary of Burden

	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	207	207	0	0	0	0
Annual Time Burden (Hours)	864	864	0	0	0	0
Annual Cost Burden (Dollars)	1,931,800	1,931,800	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $7,700,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Monica O'Donnell 202 229-8706 o'[email protected]

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Common Form ICR:  No

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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:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(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;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
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.
Certification Date: 05/08/2026

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