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Practitioners

Prior Year Instructions and Forms

Prior year instructions include mailing addresses that were in effect at the time the instructions were prepared. Since PBGC filing addresses may change from time to time, be sure to use the most current addresses (shown on our Web site or within the most current year's premium instructions).

The forms from 2001 to 2007 can be downloaded and filed with PBGC. Forms prior to 2001 are samples only. For plan years beginning in 2002 through 2007 you may file an original or photocopy of the premium form (with your original signature). All plans must file electronically for plan years beginning on or after January 1, 2007. If PBGC grants you an exemption from e-filing you can request PBGC to mail you a paper form, or for 2007 you can download the form provided below.

If you need additional forms or booklets:

  • Call: 1-800-736-2444 or (202) 326-4242; TTY/ASCII users should call the federal relay service at at 1-800-877-8339 and ask to be connected to 1-800-736-2444. OR
  • Fax: (202) 326-4250 OR
  • E-mail PBGC at premiums@pbgc.gov OR
  • Write to:
  • Pension Benefit Guaranty Corporation
    Dept. 77840
    P.O. Box 77000
    Detroit, MI 48277-0840

2012 | 2011 | 2010 | 2009 | 2008 | 2007 |2006 |2005 |2004 | 2003 | 2002 | 2001 | 2000 | 1999 | 1998 | 1997

 

2012 Estimated Premium Package2012 Premium Payment Package

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2011 Estimated Premium Package2011 Premium Payment Package

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2010 Estimated Premium Package2010 Premium Payment Package

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2009 Estimated Premium Package2009 Premium Payment Package

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2008 Estimated Premium Package2008 Premium Payment Package

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2007 Estimated Premium Package2007 Premium Payment Package

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2006 Estimated Premium Package2006 Premium Payment Package

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2005 Estimated Premium Package2005 Premium Payment Package

 

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2004 Estimated Premium Package2004 Premium Payment Package

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2003 Estimated Premium Package2003 Premium Payment Package

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2002 Estimated Premium Package2002 Premium Payment Package

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2001 Estimated Premium Package2001 Premium Payment Package

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2000 Estimated Premium Package2000 Premium Payment Package

* Note for PBGC Form 1 Filers:

In March 2000, the Department of Labor (DoL) granted an automatic extension of the time to file Form 5500 to Oct. 16, 2000. Subsequently, DoL announced that where a filer could establish reasonable cause for a late filing, the Department would not take any action as a result of the late filing. An extension of the due date for filing the Form 5500 does not extend the filing due date for PBGC Form 1.

Although certain information required for the Form 1 is based on data reported on Schedule B to Form 5500, Schedule B need not have been filed before the premium forms are filed. The premium filing may be based on the data the enrolled actuary expects to include on the Schedule B that is later filed. Should that Schedule B contain different data, an amended premium filing would be required.

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1999 Estimated Premium Package1999 Premium Payment Package

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1998 Estimated Premium Package1998 Premium Payment Package

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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1997 Estimated Premium Package1997 Premium Payment Package

n/a

+ Note about Sample Forms:

The forms are marked "Sample - Do Not Use" and are provided for your convenience. They are not to be used for the actual filing of your premium payment. Only original forms that are in Optical Character Recognition (OCR) format will enable the PBGC to process your plan information quickly and accurately. We have found that even slight variations in the printing of this form can result in errors.

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