Locating and Paying Participants

Forms and Documents

Document Name	Status
Form 703 Locating and Paying Participants Form and Instruction	Modified
Justification MYPBA screens Final.doc Justification for No Material/Nonsubstantive Change	2006-11-29

IC Document Collections

IC ID	Document Title	Status
13603	Locating and Paying Participants Form and Instruction	Modified

ICR Details

OMB Control No: 1212-0055	ICR Reference No: 200611-1212-009
Status: Historical Active	Previous ICR Reference No: 200507-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Locating and Paying Participants
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: 12/06/2006
	Date Received in OIRA: 12/04/2006
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2008	08/31/2008	08/31/2008
Responses	225,600	0	225,600
Time Burden (Hours)	118,475	0	118,475
Cost Burden (Dollars)	78,000	0	78,000

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Abstract: This collection consists of information participants and beneficiaries are asked to provide in connection with an application for benefits or request for a benefit estimate. In addition, in some instances, as part of a search for participants and beneficiaries who may be entitled to benefits, the PBGC requests individuals to provide identifying information that the individual would provide as part of an initial contact with the PBGC.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Locating and Paying Participants	705, 703, 701, 715, 719, 721, 720, 722, 702, 717, 710, 718, 706, 700, 708, 709, 707, 713, 714	Application for Elective Lump Sum ,   Payee Information Form ,   Election to Withhold Federal Income Tax from Periodic Payments ,   Power of Attorney ,   General Information Form ,   Monthly Payment Election Form ,   Financial Statement of Debtor ,   Application for Lump Sum Payment ,   Estate or Non-Spouse Beneficiary Application for Taxable Single Payment ,   Application for Electronic Direct Deposit ,   Installment Repayment Agreement ,   Beneficiary Application for Pension Benefits ,   Beneficiary Application for Pension Benefits -- OF ,   Application for Benefits ,   Designation of Beneficiary (Not currently receiving benefits) ,   Return of Employee Contributions, Participant ,   Designation of Beneficiary ,   Plan Participant Information ,   Surviving Spouse Election for Return of Participant Contributions

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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	225,600	225,600	0	0	0	0
Annual Time Burden (Hours)	118,475	118,475	0	0	0	0
Annual Cost Burden (Dollars)	78,000	78,000	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: $0

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 12/04/2006

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