OMB control number

Qualified Domestic Relations Orders submitted to PBGC

OMB 1212-0054 · PBGC.

OMB 1212-0054

PBGC needs the information contained in qualified domestic relations orders (QDROs) in order to provide benefits to alternate payees in compliance with the requirements of Title I of ERISA. An alternate payee is required to provide this information in order to obtain benefits.

The latest form for Qualified Domestic Relations Orders submitted to PBGC expires 2028-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Qualified Domestic Relations Orders submitted to PBGC Instruction

All Historical Document Collections

202603-1212-001	No material or nonsubstantive change to a currently approved collection	2026-03-09
202502-1212-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2025-02-26
202411-1212-001	Revision of a currently approved collection	2024-11-20
202112-1212-004 Approved without change	Revision of a currently approved collection	2021-12-16
201811-1212-005 Approved without change	Extension without change of a currently approved collection	2018-11-15
201510-1212-002 Approved with change	Revision of a currently approved collection	2015-10-26
201208-1212-002 Approved without change	Revision of a currently approved collection	2012-08-24
200907-1212-001 Approved without change	Extension without change of a currently approved collection	2009-07-28
200606-1212-001 Approved with change	Extension without change of a currently approved collection	2006-06-08
200310-1212-003 Approved without change	Extension without change of a currently approved collection	2003-10-29
200006-1212-001 Approved without change	Extension without change of a currently approved collection	2000-06-23
199702-1212-001 Approved without change	Extension without change of a currently approved collection	1997-02-20
199609-1212-001 Approved without change	New collection (Request for a new OMB Control Number)	1996-09-09