Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)

Annual Report for Multiple Employer Welfare Arrangements

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0116 can be found here:

Documents and Forms

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Information Collection (IC) Details

IC Title:	Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2520.101-2

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: 456	Number of Respondents for Small Entity: 73

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	456	0	456
Annual IC Time Burden (Hours)	97	2	95
Annual IC Cost Burden (Dollars)	81,900	0	81,900

Documents for IC

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