Employee Benefit Plan Claims Procedure Under ERISA

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IC Title:	Employee Benefit Plan Claims Procedure Under ERISA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2560.503-1

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:	FR Citation:

Number of Respondents: 5,900,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	320,999,996	302,999,996	18,000,000
Annual IC Time Burden (Hours)	529,000	192,800	336,200
Annual IC Cost Burden (Dollars)	423,051,994	332,469,994	90,582,000

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