OMB control number

Termination of Multiemployer Plans (29 CFR Part 4041A)

OMB 1212-0020 · PBGC.

OMB 1212-0020

Plan sponsors of terminating multiemployer pension plans give notices to PBGC about plan terminations and to plan participants about electing benefit options, and apply to PBGC for permission to pay lump sums greater than $1,750 or to pay nonvested plan benefits. PBGC uses information submitted to it to assess the likelihood of benefit reductions or suspensions and risks to PBGC and participants and to estimate the need for financial assistance to plans. Participants use information sent to them to make personal financial decisions. Plans terminated by mass withdrawal, plans terminated by plan amendment that are expected to become insolvent, and insolvent plans receiving financial assistance from PBGC are required to file actuarial valuations with PBGC.

The latest form for Termination of Multiemployer Plans (29 CFR Part 4041A) expires 2028-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 002 Actuarial Valuation Form and Instruction
Form 001 Notice of Termination Form and Instruction
Form 001 Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction
2025 Support statement part 4041A v.4.docx Supporting Statement A
2025 Support statement part 4041A v.4.docx Supporting Statement A
Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction
Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction
Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction
Termination of Multiemployer Plans (29 CFR Part 4041A) Instruction

All Historical Document Collections

202504-1212-007	Revision of a currently approved collection	2025-05-19
202205-1212-002 Approved without change	Revision of a currently approved collection	2022-05-17
201905-1212-002 Approved without change	Revision of a currently approved collection	2019-05-08
201812-1212-001 Comment filed on proposed rule and continue	Revision of a currently approved collection	2018-12-11
201807-1212-001 Approved without change	Revision of a currently approved collection	2018-09-11
201509-1212-004 Approved without change	Revision of a currently approved collection	2015-09-18
201503-1212-004 Comment filed on proposed rule and continue	Revision of a currently approved collection	2015-04-09
201401-1212-003 Approved with change	Revision of a currently approved collection	2014-03-28
201101-1212-005 Approved without change	Extension without change of a currently approved collection	2011-02-01
200802-1212-001 Approved without change	Revision of a currently approved collection	2008-02-27
200501-1212-001 Approved without change	Extension without change of a currently approved collection	2005-01-27
200109-1212-001 Approved without change	Extension without change of a currently approved collection	2001-09-25
199808-1212-003 Approved without change	Extension without change of a currently approved collection	1998-08-28
199803-1212-001 Approved without change	Extension without change of a currently approved collection	1998-03-02
199412-1212-003 Approved without change	Extension without change of a currently approved collection	1994-12-27
199411-1212-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1994-11-08
199109-1212-001 Approved without change	Extension without change of a currently approved collection	1991-09-26
198807-1212-001 Approved without change	Extension without change of a currently approved collection	1988-07-27
198503-1212-002 Approved without change	Revision of a currently approved collection	1985-03-06
198304-1212-001 Approved without change	Reinstatement with change of a previously approved collection	1983-04-07
198212-1212-003 Disapproved	Reinstatement without change of a previously approved collection	1982-12-14
198107-1212-001 Approved without change	New collection (Request for a new OMB Control Number)	1981-07-01