OMB
.report
Search
Pension Benefit Statement
Pension Benefit Statement
OMB: 1210-0166
IC ID: 242407
OMB.report
DOL/EBSA
OMB 1210-0166
ICR 202404-1210-001
IC 242407
( )
Documents and Forms
Document Name
Document Type
Lifetime APPENDIX I-II-07-21-2020-clean.docx
Other-Model
Lifetime APPENDIX I-II-07-21-2020-clean.docx
Other-Model
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pension Benefit Statement
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2520.105-3
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Model
Lifetime APPENDIX I-II-07-21-2020-clean.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:
765,124
Number of Respondents for Small Entity:
670,096
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
96 %
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
447,584,067
0
0
36,650,734
0
410,933,333
Annual IC Time Burden (Hours)
162
0
0
-19,513
0
19,675
Annual IC Cost Burden (Dollars)
471,237,675
0
0
-27,720,718
0
498,958,393
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.