Information Collection

Employee Benefit Plan Claims Procedure Under ERISA

IC 13352 under ICR 201304-1210-006 · OMB 1210-0053.

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Information Collection (IC) Details

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IC Title:	Employee Benefit Plan Claims Procedure Under ERISA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2560.503-1

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: 5,770,307	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	333,612,550	-402,852	334,015,402
Annual IC Time Burden (Hours)	523,000	16,192	506,808
Annual IC Cost Burden (Dollars)	568,700,000	58,822,963	509,877,037

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