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Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
OMB: 1212-0049
IC ID: 13583
OMB.report
PBGC
OMB 1212-0049
ICR 200711-1212-006
IC 13583
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0049 can be found here:
2024-07-09 - No material or nonsubstantive change to a currently approved collection
2024-01-19 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
Form and Instruction
Appendix 2 - Instructions.doc
Instruction
4010 screen shots
Appendix 1 - Screen Shots.pdf
Form and Instruction
4010
Appendix 3 - Form.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NA
4010 screen shots
Appendix 1 - Screen Shots.pdf
Yes
Yes
Fillable Fileable Signable
Instruction
Appendix 2 - Instructions.doc
Yes
Yes
Fillable Fileable Signable
Form
NA
4010
Appendix 3 - Form.doc
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Executive Functions
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
400
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
400
0
0
0
0
400
Annual IC Time Burden (Hours)
3,480
0
0
0
0
3,480
Annual IC Cost Burden (Dollars)
5,500,000
0
0
0
0
5,500,000
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.