Termination of Multiemployer Plans (29 CFR Part 4041A)

Forms and Documents

Document Name	Status
Form 001 Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction	Modified
2025 Support statement part 4041A v.4.docx Supporting Statement A	2025-04-30

IC Document Collections

IC ID	Document Title	Status
13529	Termination of Multiemployer Plans (29 CFR Part 4041A) Form and Instruction	Modified

ICR Details

OMB Control No: 1212-0020	ICR Reference No: 202504-1212-007
Status: Received in OIRA	Previous ICR Reference No: 202205-1212-002
Agency/Subagency: PBGC	Agency Tracking No:
Title: Termination of Multiemployer Plans (29 CFR Part 4041A)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/19/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2025
Responses	729	817
Time Burden (Hours)	32	61
Cost Burden (Dollars)	27,600	39,400

---

Abstract: Plan sponsors of terminating multiemployer pension plans give notices to PBGC about plan terminations and to plan participants about electing benefit options, and apply to PBGC for permission to pay lump sums greater than $1,750 or to pay nonvested plan benefits. PBGC uses information submitted to it to assess the likelihood of benefit reductions or suspensions and risks to PBGC and participants and to estimate the need for financial assistance to plans. Participants use information sent to them to make personal financial decisions. Plans terminated by mass withdrawal, plans terminated by plan amendment that are expected to become insolvent, and insolvent plans receiving financial assistance from PBGC are required to file actuarial valuations with PBGC.

---

Authorizing Statute(s): US Code: 29 USC 1341a Name of Law: ERISA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 11630	03/10/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 21084	05/15/2025
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Termination of Multiemployer Plans (29 CFR Part 4041A)	002, 001	Notice of Termination ,   Actuarial Valuation

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	729	817	0	-88	0	0
Annual Time Burden (Hours)	32	61	0	-29	0	0
Annual Cost Burden (Dollars)	27,600	39,400	0	-11,800	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The decrease in the estimated annual burden of this collection of information results from using an updated average number of filings actually received in the period from 2022 through 2024 and removing the requirement to file withdrawal liability information. PBGC estimates that the total annual hour burden will decrease from 61 hours to 31.5 hours, and the total annual cost burden will decrease from $39,400 to $27,600. PBGC estimates the cost savings attributed to removing the requirement to file withdrawal liability information is 10 hours and $4,000.

---

Annual Cost to Federal Government: $3,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/19/2025

---