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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0049 can be found here:

Documents and Forms

Document Name Document Type
Form e-4010 Annual Financial and Actuarial Information Reporting (29 CFR Part 4010) Form
appendix-2-instructions.pdf Instruction
appendix3-screen-shots.pdf Other-Screen shots
e-4010 Illustrative form appendix-1-illustrative-form.pdf 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: 29 CFR 4010

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	e-4010	Illustrative form	appendix-1-illustrative-form.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			appendix-2-instructions.pdf	Yes	Yes	Fillable Fileable Signable
Other-Screen shots			appendix3-screen-shots.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 560	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	560	150	410
Annual IC Time Burden (Hours)	532	-3,068	3,600
Annual IC Cost Burden (Dollars)	12,871,040	6,311,040	6,560,000

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.