OMB
.report
Search
Abandoned Individual Account Plan Termination
Abandoned Individual Account Plan Termination
OMB: 1210-0127
IC ID: 13509
OMB.report
DOL/EBSA
OMB 1210-0127
ICR 202012-1210-008
IC 13509
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0127 can be found here:
2024-05-17 - Revision of a currently approved collection
2022-03-16 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form A
Abandoned Individual Account Plan Termination
Form
PTE 2006-06(Pub. 2006-04-21).pdf
www.gpo.gov/fdsys/pkg/FR-2006-04-21/pdf/06-3815.pdf
Instruction
PTE 2006-06 Amendment 1(Pub. 2008-10-07).pdf
www.gpo.gov/fdsys/pkg/FR-2008-10-07/pdf/E8-23429.pdf
Instruction
A Notice of Intent to Terminate
model-notice A-to-plan-sponsor-of-intent-to-terminate-plan-by-qta.doc
Form
B Notification of Plan Abandonment and Intent to Serve as
model-notification B-of-plan-abandonment-and-intent-to-serve-as-qta.doc
Form
C Notice of Plan Termination
model-notice C-of-plan-termination-to-participants-by-qta.doc
Form
D Final Notice
model-final-notice D -of-plan-termination-to-ebsa-by-qta.doc
Form
404a-3 Notice of Plan Termination
Model Participant Notice 2550 404a-3.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Abandoned Individual Account Plan Termination
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
29 CFR 2550.404a-3
29 CFR 2578.1
29 CFR 2520.103-11
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
PTE 2006-06(Pub. 2006-04-21).pdf
http://www.gpo.gov/fdsys/pkg/FR-2006-04-21/pdf/06-3815.pdf
Yes
No
Printable Only
Instruction
PTE 2006-06 Amendment 1(Pub. 2008-10-07).pdf
http://www.gpo.gov/fdsys/pkg/FR-2008-10-07/pdf/E8-23429.pdf
Yes
No
Printable Only
Form
A
Notice of Intent to Terminate
model-notice A-to-plan-sponsor-of-intent-to-terminate-plan-by-qta.doc
Yes
Yes
Printable Only
Form
B
Notification of Plan Abandonment and Intent to Serve as Qualified Termination Administrator
model-notification B-of-plan-abandonment-and-intent-to-serve-as-qta.doc
Yes
Yes
Printable Only
Form
C
Notice of Plan Termination
model-notice C-of-plan-termination-to-participants-by-qta.doc
Yes
Yes
Printable Only
Form
D
Final Notice
model-final-notice D -of-plan-termination-to-ebsa-by-qta.doc
Yes
Yes
Printable Only
Form
404a-3
Notice of Plan Termination
Model Participant Notice 2550 404a-3.docx
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
25,105
Number of Respondents for Small Entity:
24,603
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
54 %
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
1,014,463
0
0
0
0
1,014,463
Annual IC Time Burden (Hours)
37,680
0
0
0
0
37,680
Annual IC Cost Burden (Dollars)
562,225
0
0
0
0
562,225
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.