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Interest Rates
Premium Filings
What's New
Mortality Tables
Reporting & Disclosure
PBGC Publications
Miscellaneous Tables
Plan Terminations
Law, Regulations & Informal Guidance
Multiemployer Plans
Risk Mitigation Program
Plan Trends & Statistics
FAQs
PBGC Forms for Practitioners
In the table below, forms and other reporting tools for practitioners are grouped by topic area:

 Some of the forms below (marked with asterisks) are for informational or illustrative purposes only – the information itself must be entered electronically.

Form Name
How to Obtain Information on Form or What Information Must Be Filed
How to Submit Information

Annual Financial and Actuarial Information Reporting (ERISA § 4010)*

e-4010 Filing Requirements [PDF]

Via e-4010

Annual Return/Report of Employee Benefit Plan (IRS/DOL/PBGC Form 5500)

Form 5500 Series - DOL Web site

Follow Form 5500 instructions on DOL Web site (page 5 of PDF instructions)

Payment of Premiums

Comprehensive Premium Filing (2009)*

Instructions and Illustrative Form (page 18 of PDF instructions)

Via My PAA

Estimated Premium Payment (2009)*

Premium Instructions and Forms

Via My PAA

Comprehensive Premium Filing (2008)*

Instructions and Illustrative Form (page 20 of PDF instructions)

Via My PAA

Estimated Premium Payment (2008)*

Instructions and Illustrative Form

Via My PAA

Premium Related Forms for years prior to  2008 (Form 1, Schedule A, Form 1-ES, Form 1-EZ)

Prior Year Instructions and Forms

Follow Prior Year Instructions

Termination Premium Form (Form T)

Instructions and Form [PDF]

Follow Termination Premium instructions (page 5 of PDF instructions)

Reportable Events 

Post-Event Notice of Reportable Events (Form 10)

PDF (See Technical Update 09-3 (April 30, 2009) for small plan reporting relief for missed 2009 quarterlies.)

Follow Form 10 instructions (page 3 of PDF instructions)

Advance Notice of Reportable Events (Form 10 Advance)

PDF

Follow Form 10 Advance instructions (page 3 of PDF instructions)

Notice of Failure to Make Required Contributions (Form 200)

PDF

Follow Form 200 instructions (page 3 of PDF instructions)

Terminations

Standard Terminations  (Full set of PDF Forms)

Notice Single-Employer Plan Termination (Form 500)

PDF

Follow Standard Termination instructions (page 5 of PDF instructions) 

Post-Distribution Certification
for Standard Termination (Form 501)

PDF

Certification of Sufficiency (Schedule EA-S to Form 500)

PDF

Designation of Representative (Schedule REP-S to Form 500)

PDF

Distress Terminations (Full set of PDF Forms)

Notice of Intent to Terminate (Form 600)

 PDF

Follow Distress Termination instructions (page 4 of PDF instructions) 

Notice of Single-Employer Plan Termination (Form 601)

 PDF

Post-Distribution Certification (Form 602)

 PDF

Enrolled Actuary Certification Schedule EA-D (attachment to Form 600)

 PDF

Designation of Representative Schedule REP-D (attachment to Form 600)

 PDF

Missing Participants  (Full set of PDF Forms)

Participant Information (Schedule MP)

PDF

Follow Missing Participant instructions (page 4 of PDF instructions) 

Annuity Purchase Information (Attachment A to Schedule MP)

PDF

Individual Information (Attachment B to Schedule MP)

PDF

Payment Voucher (Schedule MP)

PDF

  

* Forms marked with asterisks are for informational or illustrative purposes only – the information itself must be entered electronically.

 

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