Information Collection Request
Annual Information Return/Report of Employee Benefit Plan
ICR 202504-1210-002 · OMB 1210-0110 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1210-0110 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form |
Modified |
Form |
Modified |
Justification for No Material/Nonsubstantive Change | 2025-04-10 |
Justification for No Material/Nonsubstantive Change | 2025-04-10 |
Supporting Statement A | 2023-01-12 |
Supporting Statement A | 2023-01-12 |
Form Form 5500 Annual Information Return/Report of Employee Benefit Plan
Justification for No Material or Nonsubstantive Change to Currently Approved Collection_March 25_2025.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 13467 | Modified | ||
| 13467 | Modified |
Annual Information Return/Report of Employee Benefit PlanICR Details
| Status | Active |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0110 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202403-1210-008 |
| Agency Tracking No | 1210-0110 |
| Date Submitted to OIRA | 2025-04-14 |
| Requested Expiration Date | 1969-12-31 |