Reportable Events

Forms and Documents

Document Name	Status
Form Form 10 Reportable Events Form	Modified
Justification of nonmaterial change_1212-0013 Form 10 and Form 10-A.02.docx Justification for No Material/Nonsubstantive Change	2026-01-07
1212-0013 Supporting Statement 2024.03.docx Supporting Statement A	2024-04-03
Justification Nonmaterial Change Reportable Events LeapFile.02.docx Justification for No Material/Nonsubstantive Change	2023-10-20

IC Document Collections

IC ID	Document Title	Status
13522	Reportable Events Form	Modified

ICR Details

OMB Control No: 1212-0013	ICR Reference No: 202601-1212-002
Status: Received in OIRA	Previous ICR Reference No: 202404-1212-001
Agency/Subagency: PBGC	Agency Tracking No:
Title: Reportable Events
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/07/2026

	Requested	Previously Approved
Expiration Date	05/31/2027	05/31/2027
Responses	438	438
Time Burden (Hours)	1,377	1,377
Cost Burden (Dollars)	326,310	326,310

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Abstract: Under PBGC regulations implementing 29 CFR Part 4043 of ERISA, plan administrators and contributing sponsors must notify PBGC of certain reportable events. The reporting requirements give PBGC timely notice of events that indicate plan or contributing sponsor financial problems. PBGC uses the information provided in determining what, if any, action it needs to take.

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Authorizing Statute(s): US Code: 29 USC 1343 Name of Law: ERISA
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 6557	02/01/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 24882	04/09/2024
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Reportable Events	Form 10, Form 10-Advance	Post-Event Notice of Reportable Events ,   Advance Notice of Reportable Events

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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	438	438	0	0	0	0
Annual Time Burden (Hours)	1,377	1,377	0	0	0	0
Annual Cost Burden (Dollars)	326,310	326,310	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

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.     No

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.     No

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

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Common Form ICR:  No

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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: 01/07/2026

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