Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)

Forms and Documents

Document Name	Status
Form 4010 filing applic Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form and Instruction	Unchanged
4010 Justification 1-15-2013.doc Justification for No Material/Nonsubstantive Change	2013-01-15
4010_efiling_screenshots_rev screens 10 and 22 and 41.pdf Supplementary Document	2013-01-10
Appendix 2 - Instructions rev Jan 2013 CL.docx Supplementary Document	2013-01-03
4010supportingstatement2012Fin.docx Supporting Statement A	2012-03-05

IC Document Collections

IC ID	Document Title	Status
13583	Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form and Instruction	Unchanged

ICR Details

OMB Control No: 1212-0049	ICR Reference No: 201301-1212-003
Status: Historical Active	Previous ICR Reference No: 201202-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)
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: 03/05/2013
	Date Received in OIRA: 01/15/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	06/30/2015	06/30/2015
Responses	300	0	300
Time Burden (Hours)	2,620	0	2,620
Cost Burden (Dollars)	5,088,000	0	5,088,000

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Abstract: ERISA section 4010 requires the annual reporting of actuarial and financial information by controlled groups that sponsor pension plans that have significant underfunding. PBGC uses this information to detect and monitor financial problems with the controlled groups and to respond quickly when it learns that a controlled group intends to engage in a transaction that may reduce the assets available to pay plan liabilities.

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Authorizing Statute(s): US Code: 29 USC 1310 Name of Law: ERISA
  

Citations for New Statutory Requirements: PL: Pub.L. 109 - 280 505 Name of Law: Pension Protection Act of 2006

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1212-AB09	Not associated with rulemaking	74 FR 11022	03/16/2009

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 77270	12/12/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 10786	02/23/2012
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
Annual Financial and Actuarial Information Reporting (29 CFR Part 4010)	4010 filing application	4010 Screenshots

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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	300	300	0	0	0	0
Annual Time Burden (Hours)	2,620	2,620	0	0	0	0
Annual Cost Burden (Dollars)	5,088,000	5,088,000	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: The changes in burden and cost are based on revised estimates, based on PBGC's experience over the last three years. The slight increase in annual time burden from 2,600 to 2,620 hours reflects a change in the demographics of entities that are expected to file. The hourly estimated burden for each type of entity is not expected to change. The decrease in the annual cost burden from $5,167,500 to $5,088,000 reflects (based on a small survey of practitioners) a reduction in the hourly contracting rate from $325 to $320.

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Annual Cost to Federal Government: $40,446

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]? Yes

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? 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: 01/15/2013

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