Privacy Act Notice (hardship)

PRIVACY ACT NOTICE (HARDSHIP)

The Privacy Act of 1974, as amended, 5 U.S.C. § 552a (2012 & Supp. II 2014), requires PBGC to give you this notice when collecting information from you. PBGC uses this information to determine whether your financial status would justify the waiver by the PBGC of its right to collect all or some of the debt you owe the agency. Your Social Security Number is used by PBGC to identify your records within PBGC, to report income for tax purposes, and to respond to lawful requests for information about you from other individuals and entities. Your response is voluntary. However, failure to provide the requested information to PBGC, including your Social Security Number, may delay or prevent PBGC from considering your request for a waiver.

PBGC may release this information under the disclosures generally permitted under 5 U.S.C. § 552a of the Privacy Act, including but not limited to: the U.S. Department of the Treasury for cross-servicing to effect debt collection; appropriate law enforcement agencies when PBGC becomes aware of a possible violation of civil or criminal law; the Department of Justice or commercial credit agencies; whenever a financial status report is requested by the Office of Inspector General; and, any other federal agency charged with the collection of the debt or in administering the Federal Claims Collection Act. If PBGC, an employee of PBGC, the United States, or another agency of the United States, is involved in litigation, PBGC may provide relevant information about you to a court or other adjudicative body or to the Department of Justice when it represents PBGC. PBGC may also provide information about you to the Office of Management and Budget in connection with review of private relief legislation or to a Congressional office in response to an inquiry that office makes about you at your request. This information may also be disclosed for any of the PBGC general routine uses as published in the Federal Register.

PBGC publishes notices in the Federal Register that describe in more detail when information about you may be made available to others. A copy of the most recent Federal Register notice may be obtained online at https://www.pbgc.gov/about/policies/pg/privacy-at-pbgc/system-of-records-notices (PBGC-13) or from PBGC's Customer Contact Center by calling, 1-800-400-7242. If you are deaf or hard of hearing, or have a speech disability, please dial 7–1–1 to access telecommunications relay services. PBGC's authority to collect information from you, including your Social Security Number, is derived from 29 U.S.C. §§ 1055, 1056(d)(3), 1302, 1321, 1322, 1322a, 1341 and 1350 (2012 & Supp. II 2014) and 31 U.S.C. § 3711 (2012 & Supp. II 2014).

PAPERWORK REDUCTION ACT NOTICE

The Paperwork Reduction Act of 1995, 44 U.S.C. § 3501, et seq., requires PBGC to give you this notice when collecting information from you. PBGC uses the information we collect, including name, Social Security Number, date of birth, and/or other specific personally identifiable information (PII) necessary, to determine whether you are entitled to a benefit payment from a retirement plan that has terminated, and if so, to calculate the amount due to you, and to make appropriate benefit payments. Your response is voluntary. However, failure to provide information to PBGC, including your name, Social Security Number, date of birth, and/or other necessary PII, may delay or prevent PBGC from determining if you are entitled to a benefit payment, calculating the amount due, and paying the benefit due to you, if so entitled. Certain information provided to PBGC may be disclosable under the Freedom of Information Act, as amended, 5 U.S.C. § 552, and the Privacy Act of 1974, as amended, 5 U.S.C. § 552a.

PBGC estimates that the average burden of complying with the information collection request is 75 minutes (which includes 99 minutes for benefit application forms, 30 minutes for informational forms like form 701, and 14 minutes for the remaining forms), and an average of $5.13 where notary services are required to complete a form or application. These are estimates; the actual time and cost will vary depending on the circumstances and type of form or application being made. If you have any comments concerning the accuracy of this estimate or suggestions for improving this information collection, please send your comments to Pension Benefit Guaranty Corporation, Office of the General Counsel, Regulatory Affairs Division, 445 12th Street, SW Washington, DC 20024-2101. This collection of information has been approved by the Office of Management and Budget (OMB) under control number 1212-0055 (expires XX/XX/2027). Under the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.