This form is used by a plan administrator or plan sponsor of a plan to request that the Pension Benefit Guaranty Corporation determine whether a plan is covered under title IV of the Employee Retirement Income Security Act of 1974.
The latest form for Request for Coverage Determination expires 2022-06-30 and can be found here.
| Document Name | 
|---|
| Form | 
| Supporting Statement A | 
| Revision of a currently approved collection | 2025-05-19 | ||
| Approved without change | Revision of a currently approved collection | 2022-05-09 | |
| Approved with change | New collection (Request for a new OMB Control Number) | 2019-05-08 |